Last week, I made a comment at the end of a post about my son and his first asthma attack:
A high first dollar health plan (which is where the entire US system is going)
Very valued and insightful commenter JL asked a very good set of questions about my thoughts on the intermediate future of US healthcare:
” A high first dollar health plan (which is where the entire US system is going) ”
I did not realize that RM’s diagnosis of the overall direction of the US healthcare system was so grim.
Why, oh why, does the US insist on continuing this 30+ year failed experiment? It has been 30 years since Mark Pauly basically drew an X on a piece of paper and asserted that all markets were the same and like minded economists acted like, and even asserted explicitly that the market for health care was the same as the market for ice cream, and if you interfere with perfectly informed consumer decisions, its just a subsidy that will result in people consuming too much care, just as they would eat too much ice cream if the price were kept artificially low.
The thoughts below are 30% technical judgments which I believe I have some particular knowledge and insight on, and 70% political judgment where I know that I am just someone on a blog and my judgment/insight/foresight is no better than societal norm.
My basic thought pattern on this is informed by this quote on American policy making:
You can depend on Americans to do the right thing when they have exhausted every other possibility.
We still have a lot of dumb decisions with very deeply entrenched stakeholders left to buy-out before we can have a fully somewhat rational healthcare system.