Sunday, August 2, 2009

Uwe E. Reinhardt Describes the Healthcare Reform Wishlist

Uwe E. Reinhardt, professor of economics at Princeton University and one of the leading health policy experts in the world, recently wrote a biting weblog post about what Americans want from healthcare. He has proposed the ideal wish-list (NY Times, Economix Blog, July 31, 2009) :
The All-American Wish List for Health Reform
  1. Only patients and their own doctors should decide what clinical response is appropriate for a given medical condition, even if that response involves unproven clinical procedures or technology.
  2. Neither government bureaucrats nor private insurance bureaucrats should ever refuse to pay for whatever patients and their doctors have decided to do in response to a given medical condition. An insurer’s refusal to pay for a medical procedure is tantamount to rationing health care.
  3. Rationing health care is un-American.
  4. Cost-effectiveness analysis should never be the basis of any coverage decision by public or private third-party payers in health care, for to do so would put a price on human life — which, in America, unlike everywhere else, is priceless.
  5. Government should not require individuals to purchase health insurance. Such a mandate would violate the constitutional rights of freedom-loving Americans.
  6. Americans have a moral right to life-saving and potentially highly expensive medical care, should they fall critically ill, even if they are uninsured and could not possibly pay for that care with their own financial resources. (Why else would God have created hospitals and their emergency rooms?)
  7. Government should stay out of health care. Specifically, government should not control health care prices, nor should it increase its spending on health care, which is out of control.
  8. Even small reductions to the future growth of Medicare spending — called “cuts” in Washington parlance — unfairly burden the elderly, along with the doctors and hospitals that serve them and the manufacturers of health products, lest the pace of technical innovation be impaired.
He ends his post about the "common sense" approach of most Americans to healthcare with:
To be acceptable in America, health reform should not create winners or losers, but only winners. It is de minimis.
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