alt.politics.economics

INVALUABLE LESSONS FOR THE LO-LECT (LOW INTELLECT LIBS) "INANES" AND
"INSANES" HERE

WSJ BOOK REVIEW EXCERPTS

By Scott Gottlieb, a physician and resident fellow at the American
Enterprise Institute. From 2003 to 2007 he held senior positions at the Food
and Drug Administration and the Centers for Medicare and Medicaid Services.


"When ex-senators write books, they are usually gazing into a rearview
mirror, offering wistful anecdotes from a life in politics or settling old
scores. But Tom Daschle, the former Senate majority leader, isn't looking
back in "Critical: What We Can Do About the Health-Care Crisis." He is
looking forward -- to a Democratic ascendancy. Given his support for Barack
Obama and the likelihood of his prominence in an Obama administration, his
views are worth looking at closely and, well, critically.

One of the attractions of "Critical" is that it provides a more detailed
blueprint of the Democratic approach to overhauling American health care
than either Mr. Obama or Hillary Clinton has offered on the campaign trail.

The most important proposal in "Critical" is the creation of a "Federal
Health Board," explicitly modeled on the Federal Reserve Board. Its duties
would include "recommending coverage of those drugs and procedures backed by
solid evidence. It would exert influence by ranking services and therapies
by their health and cost impacts."

Mr. Daschle predicts that the board would change the entire health-care
market by forcing expanded Medicare, Medicaid and veterans programs to
follow its lead. Private health insurers would follow along, too, in part
for the political cover such a move would give them to make unpopular but
cost-conscious decisions not to pay for certain benefits.

Of course, "Critical" includes plenty of laments about the problems of our
current system, from overused drugs to insufficient preventive care. Mr.
Daschle also includes the familiar paean to Medicare's "lower administrative
costs" without acknowledging the central irony: Most of Medicare's costs are
borne by doctors and hospitals that must meet the requirements of a host of
regulations; if they do not, they may face federal investigations and
lawsuits for noncompliance. Private health plans don't have the luxury of
burdening doctors and hospitals in this way. Thus Medicare has a mere
handful of mostly generalist clinicians reviewing its coverage and payment
decisions. A large private health insurer would have to employ hundreds to
accomplish the same task.

Despite the fresh enthusiasm Mr. Daschle shows for his federal health-board
proposal, it's not exactly a new idea. Mr. Daschle himself proposed it as
part of the failed American Health Security Act of 1993. He admits that the
board is loosely based on the National Institute for Clinical Excellence in
Britain and the Federal Joint Committee in Germany. Both are charged with
managing the public's access to higher-cost drugs, medical devices and
procedures. But both are growing increasingly unpopular in their home
countries -- precisely because they've become a triumph of cost-containment
over patient access and choice.

As for America's own Federal Reserve serving as a model for Mr. Daschle's
health board: The comparison seems misjudged. The Fed has a single
price-setting role -- determining, through interest rates, the price of
money itself. By contrast, a health board would manage the pricing, and use,
of tens of thousands of medical products and procedures. How can a single
board (instead of, say, the market) make so many decisions, and wisely? Mr.
Daschle proposes a dozen or so "experts" who would be "chosen based on their
stature, knowledge, and experience, ensuring that the decisions they make
have credibility across the health-care spectrum."

Surely this is not the best way to go about reforming the . health-care
system. That it needs reforming, though, is beyond dispute. The next
occupant of the White House, whatever his party affiliation, will
undoubtedly try to broaden insurance coverage. One alternative to empowering
government agencies would be simply to help individuals buy affordable
private insurance. That effort might start by leveling the playing field
between big purchasers, who get better rates for their employees, and
individuals, who make up the bulk of the uninsured. People buying into an
expanded version of the federal employees' health plan, for instance, would
get the same tax advantages, deducting the cost of their health insurance as
if they had received it through an employer.

In the end, someone will also have to put the brakes on the unbridled demand
for health care. Ideally patients themselves will do it, in response to
market forces that expose them to the expense of their more costly
decisions. Then again, we could always just leave the work to a board of
"experts." And we may -- if a Democrat wins in November, and Mr. Daschle
gets his way.
********
A dozen or so bureaucrat "experts" running the entire US health system...not
the best way to go! Gottlieb's got that right; "Puff" Dacschle is not our
friend!!

Comments?

Dennis