August 3, 2007
Whadd're Ya Gonna Do For Me?
Somebody else be the optimist this week. I see the health care debate slipping away. Three random events have combined to give me a queasy feeling.
1) A relative who deeply distrusts Michael Moore and generally votes Republican saw "Sicko" with some friends and came away feeling that the movie made "many good points."
2) This video from the WaPo site. I deeply dislike RomneyCare and have avoided the Governor of the Commonwealth because of it. Look at this woman and her treatment by the WaPo. Then try to believe that we have any chance of avoiding socialized medicine.
I'm sorry for this woman's hardships. But she is -- let's be fair -- a crank. She begins with health care discussions, is unsatisfied even after the candidate interrupts his speech to answer her heckling, then disparages Hillary Clinton for not getting universal care passed as first lady, carpetbagging, then coveting the candidate's clothes and automobiles.
Yet she is not portrayed as a crank, she's an American woman who needs a little help.
3) Daniele Capezzone (I think he might be Italian) poignantly details the problems in Italy with Socialized Medicine, in a guest editorial for the Wall Street Journal (paid link). The problems are structural and political, having removed the system from the free market.
Part of the problem is that regional authorities manage most of Italy's health-care spending. A strike by health-care personnel has an immediate impact on the region, but the consequences of cutting the budget for medicines are only felt in the long term and distributed across the nation. Hence, local authorities continue to focus on personnel and infrastructure in an age when medical research has become the most efficient way to improve public health.Most recently, some Italian regions decided to drastically expand the scope of reference pricing, in open defiance of the central government. Reference pricing is used in most European countries to reduce government spending on medicine and is one of the reasons the Continent is lagging behind in pharmaceutical research. New drugs are grouped with existing drugs used to treat the same medical condition, and the government typically limits reimbursement to the cheapest price in the reference group. This way, patients are discouraged from using the most modern and more expensive medicine.
The Italian regions, however, are taking reference pricing one step further by grouping together drugs that do not necessarily have identical therapeutic effects. This way, the reference groups grow larger, and the regions can save more money. But patients are forced to choose between paying high out-of-pocket expenses or the risk of taking the wrong medicine.
Why does this trenchant rebuttal to Michael Moore depress me? Because few will read or understand it. Yet many will see -- and everybody will understand -- the plight of Ms. WhatareyougoingtodoforME?
I have to revisit it when I am cheerier. But maybe this pragmatist has to see that crappy, mandated, intrusive, RomneyCare is the only chance of avoiding HillaryCare. You tell people about employer-provided care as a holdover from post WWII wage controls and inefficiencies and you can see their eyes glaze over. Ms. WhatareyougonnadoforME strikes a chord.