The recognition that incremental reform is necessary is also dangerous, in that it is these sorts of windows into which corporatism can creep. Political gamesmanship, the ad hoc-ery stemming from it, and a failure to reckon with market forces are exactly the problems that got us into this mess; the way out is less government intervention in medicine, not more, and less corporate intervention, too. At least I'm not the only one talking about it.
- From Fortress to Frontier. To replicate the kinds of revolutionary innovation seen in other fields, health care policymakers need to discard the constraints of their Fortress mentality and adopt a Frontier attitude, which tolerates calculated risks and welcomes competition from diverse practitioners and disciplines.
- Address supply as well as demand. America’s health care debate has focused almost exclusively on demand: how many people have health coverage, and how providers are paid for which currently offered services. Successful reforms must ease limitations on both demand and supply, promoting innovations that can alter the nature of health care delivery and lower costs.
- Step-by-step reform. This does not require wholesale, politically unrealistic changes in the health care sector. Indeed, reformers should instead advance through many small, incremental, and simultaneous steps, seizing opportunities to break down barriers to reform, possibly achieving quick victories.
- Breaking down barriers. A vast range of such opportunities are at hand. The Fortress mentality has erected numerous obstacles to health care innovation. These obstacles are readily identifiable and can be overcome with targeted reforms that do not require a sweeping overhaul of the health care sector. The idea is to identify every potential limit on the supply of health care services, and then eliminate it. If the United States doesn’t do this, other countries will, and America will lose its leadership position in medical innovation.
Sunday, December 28, 2014
Battling Top-Down Health Care: The Mercatus Plan
I have yet to fully read the overall study, but what I've seen in the executive summary of the Mercatus Center's health care reform proposal appears entirely sound, and long overdue. Noting that the current model has turned medicine into a legal "fortress", with gatekeepers at every turn (and thus, payment), author Robert F. Graboyes suggests that (formatting below is mine, though the text is a direct quote):