1. “First, do no harm.” Legislators should keep this in mind (about a lot of stuff.)
2. If the choice to kill my child in the womb is a matter between me and my doctor, why isn’t the choice to undergo a tonsillectomy a matter between me and my doctor?
3. Subsidiarity!
The social teaching of the Church is based on the human person as the principle, subject and object of every social organization. Subsidiarity is one of the core principles of this teaching. This principle holds that human affairs are best handled at the lowest possible level, closest to the affected pesons. (Catholicculture.org; emphasis mine)
Right now, insurance companies and Medicare are driving the health-care marketplace because they cut the checks. If we want real (and cost-effective) reform, then we need to give the buying power back to the individual.
For example, I’m sure that there are patients out there (especially frail elders) who would deeply appreciate being able to get a house call. If those patients had the financial freedom to pay for one, surely someone would find a way to provide this service?
4. I’m glad that John Mackey’s op-ed is getting so much attention. I love the idea of the benefit combo of company contributions to a Health Savings Account and catastrophic insurance.
I also would love to see more HSAs offering rollovers. I’ve never started an HSA precisely because of the lack of rollover — it just doesn’t work well for us, because our out-of-pocket expenses vary wildly from year to year. I can roll over my cell phone minutes; why can’t I roll over HSA savings?
5. Speaking of articles getting attention: David Goldhill’s “How American Health Care Killed My Father” (HT ad multis) Worth it for this line alone:
How often have you heard a politician say that millions of Americans “have no health care,” when he or she meant they have no health insurance? How has a method of financing health care become synonymous with care itself?
“Not having access to health care” is living in a remote rural area where you have to drive 50 miles to get a throat culture.
And again, subsidiarity:
As a result [of insurance and Medicare policy] strange distortions crop up constantly in health care. For example, although the population is rapidly aging, we have few geriatricians—physicians who address the cluster of common patient issues related to aging, often crossing traditional specialty lines. Why? Because under Medicare’s current reimbursement system (which generally pays more to physicians who do lots of tests and procedures), geriatricians typically don’t make much money. If seniors were the true customers, they would likely flock to geriatricians, bidding up their rates—and sending a useful signal to medical-school students. But Medicare is the real customer, and it pays more to specialists in established fields. And so, seniors often end up overusing specialists who are not focused on their specific health needs.
6. Yet another reason the President and the Congress ought to stop meddling with health care: they haven’t made the correct diagnosis. They don’t understand why the system we’ve got isn’t working. How in the world could they possibly fix it?
7. And as long as they are beholden to the trial lawyers, the President and the Congress will never fix the system. Because there will be no fixing without tort reform.