The New England Journal of Medicine has an interesting op-ed piece on the failure of market-based medicine.
I agree that healthcare is a mess.
But it's not the market that's to blame...healthcare is one of the most dysfunctional markets imaginable. Consumers don't know the cost or the value of the services they get, purchasers are just as clueless, and the glaring fact that someone else is purchasing care on behalf of the consumer leads to huge dysfunction.
I've said before that I'm a supporter of a single-payer approach, but don't try to put me in a box here. Single-payer, in my mind, would involve blended government and private coverage, but with a single entity paying the bills (Medicare actually does a good job paying it's bills in a timely fashion...reimbursement is another story). Must haves:
- Must have competition that allows some providers to prosper and others to go out of business, appropriately so.
- Must have adequate reimbursement to allow especially primary care providers to stay in business, get rid of debt, and to earn a decent income at the end of the day.
- Must keep primary care and public health in the forefront.
- Must have the consumer with some skin in the game (via copayments, etc.)
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