Wednesday, October 14, 2009

Point of View taken in this blog.

Why another health care blog?

This one is primarily for my students at Wake Foretest University. It will serve as a convenient place to bring together various comments and documents (by me and and by others) concerning the general topic of health reform. To that extent, it may be of interest to others as well. That is fine. I welcome their visits and will read any comment visitors make and reply to them if it seems needed.

What do I hope will be the hallmark of this blog - the thing that makes it distinctive from others on the general topic of health reform? I hope that the content and comments here will be based on evidence from the health policy literature.

It seems to me that this objective tool is often being overlooked in favor of ideological preferences in the current debate on health reform in the United States. This is true from the most basic fact concerning the current system, for instance seniors with signs that proclaim "keep the government's hands off my Medicare," to the most lofty goals of some debatera, for instance those who insist that the only true reform of the US health care system should come through a "single-payer" system like the British National Health Service. Both of those points of view are conceptually and factually wrong, in my opinion.

The U.S system already involves the government in a big way - for instance Medicare is a government program. Likewise it is very unlikely that the U. S. would ever adopt a form of a "single-payer" system. The U.S has had a mixed "private-public" system for a very long time, and it probably will continue to have on in the foreseeable future.

The real question of health care reform is how to make that system perform better - in the public's interest instead of just in private individuals' and firms' interests. This means making it possible for private firms to make a profit. Otherwise they will exit the industry. It also mean forcing private firms to compete in such a manner that the country as a whole has broad access to high quality care at an affordable price.

Neither libertarian ideals of a free market in health care, nor the opposite extreme of a single-payer system is likely to get us there, in the U.S particularly. This blog is motivated by the hope that empirical economic and health policy evidence can contribute to a realistic discussion of this middle ground.