I’d like to draw your attention to two very excellent posts on healthcare reform.
In the first Ezra Klein identifies ten problems with the U. S. healthcare system. To Ezra’s list I’d add two more. First, that our healthcare system raises the cost of healthcare worldwide and second, that our system is unsustainable.
In the second Tigerhawk asks eight very sensible questions of healthcare reformers.
I didn’t care for all of Klein’s piece. There seemed to be a great many questions that came down to people’s perceptions of quality of care, rather than actually measuring quality of care. I’m not sure how objective measures can be found for every category discussed, but still. (In particular, measures of how much of a given country’s population wants to fundamentally restructure that country’s medical care system may have as much to do with how issues have been framed in the media. It’s no shock that American’s have a high desire to restructure our system from the ground up – we’ve been told non-stop for the last 25 years that I’m aware of that our system sucks. Amazingly, we’re still not all dead yet.)
Another issue I had concerned the issue of chronic diseases. A great deal of our problems with that our because of behavior that has nothing to do with our medical system. I can’t blame being over-weight on my doctor, just as my mother can’t blame her smoking for 60+ years on her doctors.
As to your point that we raise costs world-wide, I believe it’s also true that we shoulder a larger burden of R&D work, isn’t it? (I know I’ve heard that, but I’m not sure how true it is. I’m hoping you have the answer readily available.)
Finally, Klein starts his final paragraph with this:
He then lists several areas where we do in fact hold top positions. However, his opening statement isn’t true. We spend tons of money on primary and secondary education, with especially poor results in our secondary education.
(There are other areas where we have poor results, but we often don’t spend much on them; e.g., public transportation.)
Whoops, I wrote the above before reading Tigerhawk’s post (and by extension, Mankiw’s column in the NYT). Please feel free to delete my prior comment and this one, as any points I make are better made in those two items.
Also, while I do have some problems with Klein’s article, I should stress that it also makes many valid points. Other than being highly suspicious of the government running the healthcare system any more than they already do, I don’t have a horse in this race.
It’s somewhat difficult to do a reasonable comparison of R&D expenses in this day in which the field is dominated by multi-nationals. Is research done in the United States for reasons of more advantageous intellectual property law by a Swiss company U. S. R&D or Swiss R&D?
Dave, in the example you mention it would be fairly easy to ascertain: Would the Swiss company have done the R&D in Switzerland if the US intellectual property laws were the same as Switzerlands? If not, we should get credit for it. (I mean, if they do the research here just to gather more marginal benefit, don’t count it as US R&D. If they did it here because doing it anywhere else would just be an automatica loser, only then should we get credit.)