walkitout (walkitout) wrote,
walkitout
walkitout

snarking on lifeboats, then I'm off, I swear

http://well.blogs.nytimes.com/2009/01/19/how-should-obama-reform-health-care/

Pointing to this:

http://www.newyorker.com/reporting/2009/01/26/090126fa_fact_gawande?currentPage=1

Atul Gawande is the guy whose book _Complications_ I enjoyed, but whose book _Better_ I felt (like some other reviewers on Amazon) was worse. I've watched/listened to him speak on BookTV; he seems personable and intelligent. His commentary on medicine is a bit hit or miss, but distinctly different in his misses than Sanjay Gupta (the guy over at CNN rumored for the Surgeon General post -- if you got them mixed up, you aren't alone). Gupta misses in ways that make me wonder if he's awake and paying attention; Gawande, I feel, is overly optimistic about his chosen profession.

In any event, this is the quote I will snark on:

"On the start date for our new health-care system—on, say, January 1, 2011—there need be no noticeable change for the vast majority of Americans who have dependable coverage and decent health care. But we can construct a kind of lifeboat alongside it for those who have been left out or dumped out"

Once upon a time, the state of Florida had a bit of a crisis on their hands, as home insurance companies were exiting the state in droves or quoting policies that were clearly out of reach. So the state of Florida created a stopgap, a state owned insurance pool you could get home owners insurance through when you couldn't afford to get it anywhere else.

Guess what? Everyone now gets their insurance through the state. (For suitable values of everyone.)

https://www.citizensfla.com/

Here's one perspective on how that's going:

http://www.sun-sentinel.com/business/sfl-flzcitizens0107sbjan07,0,7388596.story

I'm all in favor of reforming health care. I have yet to hear a proposal that I think is really great. Me, I think we should institute a wealth tax and use it to fund health care for everyone and implement it in conjunction with draconian regulation of Pharma, Medical Devices, etc. I also think we should do something Really Really Dire to the AMA, and pull licensing of medical professionals into the government; having a trade association do that is just silly.

I recognize that no one else is going to sign on to this program, so I basically don't much care what else we do, but I would like to improve access. Gawande's idea (like Obama's, Hillary's and everyone else's) that we start small and expand is plausible. Every other metastasized aspect of the medical-industrial complex started small.

But that lifeboat is either going to sink or bloat.
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