President Bush's purported health insurance SOTU proposal has been leaked and the economist-blogosphere is buzzing with instant analyses. I've read about 10 and not one - that's right, ZERO - seem to address the fundamental underlying problems:
- Providing all the medical care we now have to everybody.
- Including the growing number of "uninsurables" (thanks to rapidly improving screening such as genetic testing) outside groups or self-employed.
Health insurance is simply a way to hand the bill around. It does nothing to tackle the hard problem of how many liver transplants a person is allowed, or whether to do bypass surgery on a 90-year old or how does a 25 year-old independent trucker with genetic markers for MS get coverage.
Our problem is not just medical insurance. It's paying for all the medical care we now can provide, such as drugs and procedures never imagined 10 years ago. And for how long? The expenditure of increasing portions of our economic output in the final few months of lives is a growing problem that nobody want to tackle, even as it threatens to consume us.