A hundred years ago, if you got sick or injured there was not a whole you or anyone else could do about it. Lots of people died.
Today we have a treatment for almost any illness, from cancer to impotence. Today we have a different problem: we have to make decisions.
Will you get the treatment?
Who will pay for it?
How much will you spend?
Looking at our waistlines, it is pretty obvious that we are not very good at making difficult decisions and sticking with them.
Which is a big part of our healthcare "problem" today and why I am so doubtful that Congress and President will do anything of consequence about it. Our "solutions" are almost always the lowest cost, easiest short-term thing to do, whether or not they actually fix the problem or cost more in the end.
This week's story on This American Life is a must-hear for anyone interested in our current health care discussion.
As I listened to the historical segment, I realized that I have heard reports on the health system in other countries but I have never heard anyone report on where our system came from.
Other countries seems to have a system with a coherent goal: cover everyone.
Who is the genius architect behind the most advanced, most expensive, and most inconsistent system in the world?
It turns out that the answer is no one. Our system was never designed; it grew out of a few seemingly unrelated decisions and a lot of individuals pursuing their own profit. In other words, no one ever made the tough decisions to design a comprehensive system with a cohesive goal.
That is why the system we live with is so frustrating.
That is also why it seems so unlikely that anyone now will redesign it into something with a coherent, logical strategy.
Eventually we will simply run out of money. People with solvent health care coverage will get treatment. Everyone else will do it the way it was a hundred years ago.
392: Someone Else's Money
10.16.2009
This week, we bring you a deeper look inside the health insurance industry. The dark side of prescription drug coupons. A story about Pet Health Insurance, which is in its infancy, and how it is changing human behaviors—for example, if you have the pet health insurance, you bring your pet to the vet more often, and the vet makes more money and...well, you can see the parallels. And insurance company jargon, frighteningly decoded.
Prologue.
Host Ira Glass describes the crazy world of medical billing, where armies of coders use several contradictory different systems of codes...and none of it makes us healthier. (5 minutes)Act One. One Pill Two Pill, Red Pill Blue Pill.
Planet Money's Chana Joffe-Walt explains why prescription drug coupons could actually be increasing how much we pay, and prevent us from even telling how much drugs cost. (13 1/2 minutes)
Act Two. Let's Take Your Medical History.
Alex Blumberg and Adam Davidson recount how four accidental steps led to enacting the very questionable system of employers paying for health care. (11 1/2 minutes)
Act Three. Insurance? Ruh Roh!
Planet Money correspondent David Kestenbaum investigates the growing popularity of pet insurance, and what it reveals about insurance for people. (14 minutes )
Act Four. Sorry Johnny... It's Only Business.
This American Life producer Sarah Koenig reports on a very surprising reason why insurance companies dump members, and how this reasoning contradicts President Obama's argument for what will lower health care costs. (11 1/2 minutes)
