Awesome article Matt posted yesterday. My favorite passage:
The third class of health-cost proposals, I explained, would push people to use medical savings accounts and hold high-deductible insurance policies: "They'd have more of their own money on the line, and that'd drive them to bargain with you and other surgeons, right?"
He gave me a quizzical look. We tried to imagine the scenario. A cardiologist tells an elderly woman that she needs bypass surgery and has Dr. Dyke see her. They discuss the blockages in her heart, the operation, the risks. And now they're supposed to haggle over the price as if he were selling a rug in a souk? "I'll do three vessels for thirty thousand, but if you take four I'll throw in an extra night in the I.C.U."-that sort of thing? Dyke shook his head. "Who comes up with this stuff?" he asked. "Any plan that relies on the sheep to negotiate with the wolves is doomed to failure."
Which reminds me of a one-act play I wrote on "free-market" health care a while back...
In any case, the particular thought that this article dislodged was related to the rhetoric we constantly hear about executive bonuses for the banking and other industries, where a few corporate executives reap millions in bonuses, oftentimes while manning the wheel of a poorly run venture. Like, say, the banking industry. If executive pay is capped, the industry won't attract the "best and brightest."
But as this article points out, and as was evidenced by the collapse of the nation's financial industry, those that work primarily for financial rewards in their given industry will put financial considerations first.
And that's often not for the best. Have to choose between safe, stable investments with a lower return, or risk the nation's economy on potentially high yielding derivatives? We know what our nation's investment banks chose. Have to choose between inexpensive health care that better addresses your patient's health, or expensive, and oftentimes, ineffectual health care that helps out with your vacation condo's payments? Depends on the kind of ethics you have, and what kind of medical facility you work for.
It's time to face the fact that oftentimes the "best and the brightest" are not motivated primarily by money. |
