Health Care Discussion

Washington Post columnist Steve Pearlstein, took questions from all comers: the resulting transcript is here. I encourage you to read through the discussion, it's a good primer on Healthcare and the politics of reforming it.

He admits that if the US were starting from scratch, a National Healthcare system would receive a lot of consideration -- but current political reality dictates that we concentrate on reforming our current private-insurance system. Some interesting tidbits:


Steven Pearlstein: ... The problem is that this "market" isn't really a market since drug prices overseas are dictated on a take-it-or-leave-it basis by foreign governments and their national health plans. What we need is for drugs to be priced in every country according to that country's ability to pay, which would be the cost of materials an dproduction in the case of poor African countries and the highest in the US -- but still below where they are today. The folks who are getting a free ride on drugs these days are the Japanese, the Europeans and some mid-income countries.


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Boston, MA: I haven't heard much discussion of actual health -outcomes-, where the US lags most of the developed world -- e.g. on life expectancy and infant mortality.

Your suggestions are focused on fixing some of the financial aspects of the current system, but the experience of Japan, Canada, Britain, and Europe is that national coverage produces much better outcomes at lower cost.

Steven Pearlstein: Yes, it has. But if you read the literature further, you'll find that some of that has do with factors other than whether the health system is nationalized or not. And there is some unhappiness most of those countries you mention, along with Canada, with the system right now, which is bumping up against some of the same problems ours is. As I say, if you were devising a system from scratch today, you'd probably do some version of a national health plan. But that's not where we are, and we can waste a whole lot of energy and political capital trying to get there, only to discover that this country just won't do it. So why not deal with the world as it is, not as we'd like it to be.