Parting Thoughts

I will be traveling for the next week, but my trusty laptop and a free Broadband connection will keep me blogging, albeit at a somewhat slower pace.

As a parting thought, I must point out that Holland has undergone a terrific health reform. The Health Economist has a deep, penetrating and positive analysis. My impression is the latest reforms puts the Dutch more in line with Germany, if I understand the semi-private sickness funds correctly. I recognize that a government requirement that everyone purchase health insurance is a problem.

I have to hold my nose since I don't think the government should tell me what to do. It is one of the reasons I left Canada. However, I'm willing to accept the notion because I will share in the collective benefit realized by a reduction in the societal costs associated with uncompensated care.

The obligation to buy health insurance has reduced the number of uninsured slightly in Massachusetts [for an explanation of the is contradictory information being trumpeted by the demagogues of the right, see here.] The reduction is much smaller than I had expected, but the enforcement mechanism is through taxes and we have yet to complete a full fiscal year. Only time will tell.

It heartening to see the Governator has the clarity to build a consensus around the issue. Hospitals are among the most powerful interests in health care, along with the insurance industry, and they appear to be on board. Sure, the docs are important, but let's get real. That's a lot of money in hospitals and insurance...

In the end, I am somewhat heartened by the consumer movement in health care. When the rubber meet the road (in health care, it means the patient has met the doctor) health care has to work in the context of a relationship: the doctor-patient relationship. Without it, throw the whole thing in the waste-basket; nothing will work. I have stories... I have stories. I will share more of them at some point, because I have to keep reminding myself that policy has nothing to do with facts or data or science. It has to do with money, power and stakeholders jockeying for position (also known as politics.)

Let's make sure the patients don't get lost in the shuffle between the powerful and the moneyed.