How It Got This Way

Paul Craddick emailed me a link to an article by Dale Steinreich that gives some of the background for understanding the mess that healthcare has become. It's worth a few minutes, if you've any interest in the topic. Apart from the history lesson, Steinreich offers the following suggestions:

A first step toward genuine health freedom would be an elimination of all federal restrictions on supply and demand factors in medical markets. This means no more millions of dollars in federal subsidies to hospitals to train fewer doctors, and the abolition of Medicare and Medicaid. Medicare and Medicaid have only worsened the problems in the health-care sector by adopting Blues-type practices which have in turn encouraged an over-consumption of health care services among the poor and elderly.

Beyond this point free-market health-care reform becomes a tricky matter since some of the most oppressive restrictions (physician and hospital licensure, restrictions on midwives and pharmacists) have been enacted at the state level. It would be a violation of states' rights to advocate that the federal government override these restrictions.

Steinreich is understandably frustrated by public apathy. That's the difficult part of balancing reasonable policies on specific issues with democratic principles. It's a shame, though, that he ends on the sour note of slurring the public for its ignorance. Coming up with a policy is the (relatively) easy part; convincing others why it's better than one crafted by politicians, special interests, and demagogues is the challenge, and it's much more easily met with optimism.