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Tuesday, April 12, 2005

Krugman on Ailing Health Care

My thanks go to Ed Parkhurst, Chuck Kleber, and Milton Hinshaw, each of whom called to my attention Paul Krugman’s column of April 11, 2005 entitled Ailing Health Care. Krugman is a liberal economist whose columns appear regularly in the New York Times.

The column dealt with rising costs, the uninsured, the reluctance of politicians to raise taxes, and the “wildly inefficient” U.S. health care system.

Krugman predictably leans towards governmental solutions and suggested that we need to shed “….the ideologically driven belief that government is always the problem and market competition is always the solution.”

I (together, no doubt, with a few thousand others) sent him an e-mail. This is what I said:

“Effective reform involves a lot more than shedding preconceptions about public versus private solutions.

In our system of providing health care services, nobody is in charge. Until that is fixed, reform will be slow and difficult.

The health care professions are organized according to a sort of medieval guild system. That inhibits the efficient utilization of manpower and needs to be diluted.

Systems – as contrasted with individuals - play an ever-increasing role in modern health care. The excessive independence we grant to health care professionals stands in the way of improving systems and, therefore, needs to be markedly reduced.

And those are just for starters.”

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