I’ve decided it’s a good evening to wax Platonic a little bit and write in dialogue form.
Interviewer: I see you like to study health policy. What do you think are the biggest problems with our healthcare system today?
Taylor: Cost, quality, and access; we spend way too much money and still don’t have relatively great outcomes or access to care.
Interviewer: How do you think we can solve them?
Taylor: You missed a question.
Interviewer: What do you mean?
Taylor: Didn’t you mean to ask me what’s causing the problems before you asked me how to solve them?
Interviewer: *Gives me the “go on” look*
Taylor: Well, you’ve just exemplified the secret (fourth) problem of healthcare: ignorance. We skip the second question. We don’t really understand what’s causing the problems we identify. Instead, we jump right to ideas about how to solve them (i.e., answering the third question). So, go ahead and try again.
Interviewer: Thank you, but that will be all. And remember, don’t worry about calling us–we’ll call you.
This is my explanation for being so slow to form an opinion on reform proposals. I don’t really know what would help yet because I don’t really understand all the root causes of the problems. I guess one can probably never understand all of the root causes, but one can surely understand the two or three main ones to each problem. And there doesn’t seem to be a single place online or anywhere that I can go to find them clearly laid out and thoroughly explained. It’s probably because we keep skipping the second question.
Now if only I could figure out what justice is . . .
This is exactly where I feel that I’m at. I don’t know how I feel about all the reforms because I don’t know how I feel about the current situation either. The complexities and intricacies of the healthcare scare the general public from going out of their way to research and gain understanding. Many physicians don’t fully understand it either!
Jake, I have felt the same way for the longest time. The good news, though, is that I am starting to feel like I’m getting a grasp on what I’d like to see happen with our healthcare system. The focus so much is on how to pay for it and how to improve access. But both of those problems will be taken care of if healthcare can transform itself to a lower-cost industry (and I believe it can). If it does that, then the problem of how to pay for it will be mitigated and the access problem will start to resolve itself too. (Remember, the main reason people either can’t get insurance or choose not to get insurance is because it is crazy expensive!) I say “transform itself,” but I don’t think that means we should just employ a hands-off policy as we passively watch and wait for healthcare to fix itself. No, there are definitely things the government can do to help. And there are things academia can do to help. I think this topic will be what I blog about for the next little while.