A cogent, and funny, observation on health care costs

I don't agree with the premise, but I rather liked Gail Collins' aside ...

Health Care Follies - The Conversation Blog - Gail Collins - NYTimes.com

... The big problem is that the economy is sinking under the rising cost of medical treatment, one cause of which is doctors recommending unnecessary and overly costly procedures. (For which I do not blame the doctors. If we lived in a desirable world in which people were insured against not getting enough news, I can guarantee you that I would come up with some really excellent additional products.)...

She really is a wonderful writer, and she's getting better.

Unfortunately, as recently illustrated by Atul Gawande, the premise is sadly simplistic. It's not simply that all these procedures are "unnecessary", it's rather that most people, if they had to pay for them, would choose something cheaper even it were less effective.

So if we had to pay for our shoulder MRIs, we'd probably give "rest" a longer try before looking for a (probably inoperable) rotator cuff tear. If we had to pay for our anterior cruciate repair, we might decide to live without inline skating -- like we used to.

This is why these decisions are much more troublesome than anyone but an unpaid blogger is willing to publicly acknowledge.

We won't really get universal coverage until we close our eyes, grit our teeth, seal our nostrils, and embrace crummy care (aka "good enough" care).