Another Perspective on Health Care

This article from The Atlantic is certainly thought-provoking. Now, I can't vouch for the veracity of the author's statistics or other claims, but at face value it's a compelling article. A few items that I zeroed in on while reading it:

• This excerpt below reminded me of Bjorn Lomborg's take on global warming, that's it's really not so bad, when compared with all the other bad stuff that we could be spending money trying to mitigate:
  

  As a nation, we now spend almost 18 percent of our GDP on health care. In 1966, Medicare and Medicaid made up 1 percent of total government spending; now that figure is 20 percent, and quickly rising. Already, the federal government spends eight times as much on health care as it does on education, 12 times what it spends on food aid to children and families, 30 times what it spends on law enforcement, 78 times what it spends on land management and conservation, 87 times the spending on water supply, and 830 times the spending on energy conservation. Education, public safety, environment, infrastructure—all other public priorities are being slowly devoured by the health-care beast.
  
  By what mechanism does society determine that an extra, say, $100 billion for health care will make us healthier than even $10 billion for cleaner air or water, or $25 billion for better nutrition, or $5 billion for parks, or $10 billion for recreation, or $50 billion in additional vacation time—or all of those alternatives combined?

• Why does health insurance work so differently from every other form of insurance?:

  Health insurance is the primary payment mechanism not just for expenses that are unexpected and large, but for nearly all health-care expenses. We’ve become so used to health insurance that we don’t realize how absurd that is. We can’t imagine paying for gas with our auto-insurance policy, or for our electric bills with our homeowners insurance, but we all assume that our regular checkups and dental cleanings will be covered at least partially by insurance. Most pregnancies are planned, and deliveries are predictable many months in advance, yet they’re financed the same way we finance fixing a car after a wreck—through an insurance claim.
  

  Insurance is probably the most complex, costly, and distortional method of financing any activity; that’s why it is otherwise used to fund only rare, unexpected, and large costs. Imagine sending your weekly grocery bill to an insurance clerk for review, and having the grocer reimbursed by the insurer to whom you’ve paid your share. An expensive and wasteful absurdity, no?

  Is this really a big problem for our health-care system? Well, for every two doctors in the U.S., there is now one health-insurance employee—more than 470,000 in total. In 2006, it cost almost $500 per person just to administer health insurance. Much of this enormous cost would simply disappear if we paid routine and predictable health-care expenditures the way we pay for everything else—by ourselves.

• We hear a lot about how other nations' citizens have it better-off because of universal coverage. That might be true, but evidently they're struggling with rising costs too (of course, their care costs, on average, are still much cheaper than ours):
  

  Whatever their histories, nearly all developed countries are now struggling with rapidly rising health-care costs, including those with single-payer systems. From 2000 to 2005, per capita health-care spending in Canada grew by 33 percent, in France by 37 percent, in the U.K. by 47 percent—all comparable to the 40 percent growth experienced by the U.S. in that period. Cost control by way of bureaucratic price controls has its limits.

So what does it all add up to? Should we ("we" being the government, in theory, anyway) not even bother to attempt any incremental fixes, since they probably won't work? Will this round of supposed reform set the stage for a future, more positive round, or leave the public too frustrated or indifferent to try again?

The author's proposed solutions (on page 6 of the article) are attractive and certainly seem to make sense, but I suspect that we're already stuck too far down in the system; if people are up in arms about relatively modest changes, how would we ever succeed in so fundamentally changing the way that health care is paid for?