The Case for Health Care Reform
By Arnold Kling
In France, by contrast, you walk to the corner pharmacist, get either a prescription or over-the-counter medication right away, shell out a dozen or so euros, and you’re done. If you need a doctor, it’s not hard to get an appointment within a day or three, you make payments for everything (including X-rays) on the spot, and the amounts are routinely less than the co-payments for U.S. doctor visits. I’ve had back X-rays, detailed ear examinations, even minor oral surgery, and never have I paid more than maybe €300 for any one procedure.
I believe that America’s health care system should be reformed. Medicare is unsustainable. Employer-provided health insurance should never have been instituted in the first place, and it is becoming more dysfunctional every year. I would like to deal with the structural issues that bias our system in favor of specialists, fragmented care, and credentialism. Americans need to learn how to make reasonable judgments about medical procedures that have high costs and low benefits.
None of these problems is addressed by the bills in Congress. This year’s health care debate is proof that top-down reform is not going to work. The more the system is politicized, the less likely it is that it will change. The only direction for reform is market-oriented policy that by today’s standards seems radical and unacceptable. In contrast, the politicians are struggling mightily to do what amounts to minor tinkering and tampering.