By Arnold Kling
My latest essay is on health care policy.
America’s health care system has many flaws. However, the solution is not to enlarge government’s role. What I would like to see is a role for government in health care that is streamlined, rationalized, and bounded. I call this approach “limited paternalism.”
I call for shrinking the number of people on Medicare and Medicaid, while increasing subsidized health clinics in poor neighborhoods and taking steps to make it easier for individuals to obtain health insurance directly, rather than through employers.
Can the market help deliver cheaper, better health care? Consider this story from the New York Times.
The clinics, called MinuteClinics, are cropping up in Target and Cub Foods stores in the Minneapolis-St. Paul area. Now in 10 stores, the MinuteClinics aim to diagnose and treat about a dozen common ailments – like strep throat, sinus and ear infections and seasonal allergies – in about 15 minutes. They also provide vaccinations and offer screenings for cholesterol and blood pressure problems.
The article quotes some doctors who object to this sort of health care innovation. One argues that you are better off going to an emergency room. “Often, he said, patients come to emergency rooms complaining of minor ailments that turn out to be more serious. A patient who thinks she has strep throat, he said, may have an abscess, while a supposed cold sore could be a sign of a sexually transmitted disease.”
In my opinion, if you want a thorough medical exam, the last place you should go is an emergency room. Recently, my father went to the emergency room for a knee injury, and he was sent home with a soft brace and a diagnosis of a broken femur. Say What??? The treatment was totally inconsistent with the diagnosis. Fortunately, it was the diagnosis that was wrong. The orthopedist who saw him ten days later said that there was absolutely no broken bone, but that my dad had cellulitis, which is a skin infection that causes swelling and inflammation.
Sorry, doctors, but you won’t get me to sign that petition to ban minute-clinics and force people to use emergency rooms instead. Let the market decide.
For Discussion. How might government and private sector programs be combined to make health care better? How might they be combined to make it worse?