The Right Turn

I talked in the post below this one about how our current health care system gives us the worst of both worlds. Double the bureaucracy, none of the benefits of either system. Like many have fervently suggested, we can take a left turn and look to France. I agree that this would be a good solution. Politically difficult for sure, but ultimately rewarding. But hey, just for the giggles, lets look at how we can also improve things by taking a right turn. By this I mean that there are interesting market-based solutions out there. Whether they're any more politically feasible than socialized medicine is up for debate.

1) Insurance is not our friend
This post from the Healthcare Blog confirmed what I have long, long suspected: "Competition amongst health plans and HMOs is not about the competition to produce the best quality care. It's about the competition to insure as many as possible of the people least likely to need it."

That, my friend, is the #1 reason why there is failure in our healthcare market. Insurers survive by cherrypicking clients (and in the case of HMOs, being stingy with care). Meanwhile, healthcare consumers maximum their benefits by taking an "all-I-can-eat" attitude. Meanwhile, doctors are not rewarded for giving the best care but for performing as many procedures as possible. Counterintuitive as it seems, we've got to discourage the use of insurance for healthcare if we want market forces can do its work. At the very least, we need to make it illegal for doctors to charge uninsured individuals more than insurance companies for any given procedure.

2) We can't all ride Cadillacs all the time
Many minor ailments simply does not justify expensive treatment by a medical doctor. Why aren't there nurse-practitioners who offer low-level healthcare services for a fraction of the price? If they do detect something out of the ordinary, then they refer you to a doctor. The idea that I have to choose between no care and the best care at a steep price is antithetical to healthy markets.

3) Big Pharma has gotta go down
No more whining about R&D expenses -- they spend many times that in marketing costs. Have you ever seen those commercials that just show sunshine, puppydogs and shiny happy people ending with "Ask your doctor about...."? They don't even bother telling you what their newest magic bullet is supposed to do anymore.

Open the border to Canada for prescription drugs. If they want to gouge prices, they can't just gouge us. Then, the U.S. government should become aggressive in patenting their own medical advances -- if a pharmacutical company makes a drug that was developed mostly with taxpayer dollars, they should pay royalty. Introduce tougher patent laws to whittle away their monopoly rights -- maybe making pharma companies auction off licenses to make the drug, maybe introducing a system where generic makers pay a percentage of sales to the developer as compensation.

If we see a serious dearth of innovation, the government should offer bounties for the development of better drugs. Imagine if we take the amount we're overpaying big pharma by in Bush's medicare prescription bill and turned it all into bounties. I find it hard to believe that medical progress would come out behind.