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Tomaino Arm Care Network

Dr. Tomaino's Blog

Health Care Reform: Market Forces Must be Involved

August 21st, 2009
Many of my patients have asked me to weigh in on this topic in general, and President Obama's vision for a public option, in particular. One thing is for sure, notwithstanding the political expediancy of proclaiming the need for reform and a solution, it's not at all a straight forward problem to solve.

Clearly health care costs are exhorbitant, but this is more complicated than arguing that technology is too expensive or that providers and insurance companies get paid too much. An insufficient emphasiis on healthy living as well as an expectation that technology ought to enable us to live longer and healthier has fueled an industry that rewards a plethora of options. Fueled by increasing demand and consumtion, it's no surprise that total costs keep increasing, and no surprise that "managed care" is another way, often, of rationing or withholding care.

Those who can pay can continue to consume, and those who cannot are faced with increasing costs, in part, related to the economic impact of supply and demand.

Because our health care industry is not one with unlimited capacity--hospital beds, outpatient clinics, doctors and nurses, barriers to irresponsible consumption will exist. These, in my opinion, will be imposed both on the basis of price as well as on the basis of outcome data and best practices.

Reform, in the absence of any assignment of personal accountability for health and consumption of resources, will likely fail. Additionally, there will always be offerings within the industry, like any other, where those folks with unlimited resources will be capabale of "over-consuming" if they can afford to. Governments role ought to be looking out for those who try their best to live healthy and yet still have trouble gaing access to an expensive system.

Until we regard health care expenditure more like spending money on entertainment, electronics, food and shelter, etc.----offerings which we need to pay for to receive-- we will be at risk of treating health care as an entitlement.

Entitlement----maybe. But if we are looking for a solution, we need to embrace the fact that the healthcare industry is made up of people who have jobs and also need to consume------therefore, somehow we need to generate the revenue to cover the cost.

Higher taxes? Less consumption? Public option? Maybe.

Single payor? Eliminate market forces?

When has eliminating competition ever worked?

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