Sunday, April 18, 2004

The New York Times > Magazine > The healthcare policy issue

The New York Times > Magazine > Now Can We Talk About Health Care?

The NYT Magazine focused on healthcare policy this week. The articles were so vapid I only scanned them. I was left with these probably unfair impressions:

1. Hilary doesn't like "Consumer-driven healthcare" (aka "defined contributions", "medical savings accounts", etc). She favors managed care. I though her objections to "defined contributions" were very weak, but they were political objections, not thoughtful objections. (There are thoughtful objections, but they require thinking about unpleasant things -- like rationing.)

2. A fairly healthy couple complained about their inability to get cheap coverage. They seemed to think it was fine for sick people to pay a lot -- just not healthy people.

3. A primary care doc blamed the implosion of primary care on the gatekeeper fiasco. She seemed to miss the effect of employer-driven care plan switching; that alone would have destroyed a care system based on longterm relationships.

I guess things aren't bad enough yet to trigger a real discussion. Let's try again in three years.

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