Who Killed Health Care?

Monday, August 06, 2007

Of all the recent proposals to reform the American health care system, few have been focused on the strength of a free market. Regina Herzlinger explains how capitalism - not European-style social welfare policies - can fix what ails us.

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Regina Herzlinger

Comments [16]


First, it should have been mentioned that the guest is affiliated with the Manhattan Institute.

She engaged in much misinformation. Some examples: buying a car is NOT the same as buying health insurance! Is this not obvious? More specifically, re the Swiss system: efficiency is not gained by consumers buying their insurance individually, but by the extent of basic coverage being mandated by law, which means that consumers will not be unwittingly under-insured.

Aug. 08 2007 12:48 PM
deniz from switzerland

Jon Pope is right. Switzerland has only 7-8 million people. As one caller stated, one reason the system works is that there are fewer poor people and the state helps out those who can't afford it. The guest responded by stating that we are spending more money here without getting results anyway. That doesn't mean that if we switched to the type of program she wants costs would necessarily decrease. In fact, it could be equally as bad because of the high poverty rate in the US. You can't just take another country's system and slap it on your own.

I am an American living in Switzerland and although from what I understand it is a fairly good system, it too has problems. The costs are skyrocketing here, and this is according to the Swiss people that I have talked to here.

It's a mixed bag, but I think people have to realize that in the end, we have to pay for our health care, whether through private care or taxes. Nothing is free, but some systems are more humane than others. In the end, it's a societal choice that we have to make, as Michael Moore says.

Aug. 07 2007 10:41 AM
Peter from New Jersey

I have yet to hear it mentioned in the health care debate that it is the American Medical Association that controls the number of medical schools that graduate doctors, hence the "supply side" of the equation is artificially set low allowing medical costs to continue to skyrocket. Which is just the way "they" want it.
"Free market?" What free market? What we're suffering through is the GREAT HEALTHCARE DEPRESSION of the NEW MILLENIUM for the 43 million who will trade their no money for their health/lives. As in the 30's, the government had to step in, will have to step in- to take control of so many diverse forces. But those powers that be won't allow it. Unless-as Ms. Herzlinger mentioned just might be happening- big business realizes those health care costs are killing them too.

Aug. 06 2007 03:30 PM
Judith Kozloff from New York

Can I assume that Regina Herzlinger holds the Aetna chair at the Harvard Business School?
I have never listened to such a poor arguement which will only promote further inefficiencies in the system. the perfect capitalist non-solution, and certainly not cost effective either for business or the economy.
Health care is NOT a perfect market and never can be. When I went to Cornell Weill earlier this year with a life threatening sudden need for emergency surgery despite my comprehensive health insurance I was in no position to research the best/lowest cost provider.
Comparing the UK system and finding it wanting is a favourite hobby horse ( yes I am British).
But overlooks the simple fact that it is much cheaper per capita ( probably too cheap) than the US system and while far from perfect provides access to everyone-including American tourists. Americans with insurance have a tendency to spend to try to preserve life at all unreasonable cost- a disportionate amount is spent on the last six months of life. Europeans are somewhat more pragmatic about useless expenditure. ( And yes I feel the same way were a member of my family to find itself in this position). Extending Medicare would be a good place to start - not to curtail it as the current administration wants to do.

Aug. 06 2007 02:25 PM
Andrew D. from Skokie, IL

When I heard this I was so glad. It's about time that people start to talk about the absolutely horrendous,
mismanaged organization that is our healthcare system.
The way that HMOs are currently set up, people with
illnesses or injuries that would be easily cured (if
treated promptly) go untreated for long periods of
time, fester, and are allowed to be serious, potentially
life-threatening illnesses. Senior citizens often have to chose between buying
food and buying life-saving medications. It truly is deplorable. Clearly
the system cannot be allowed to continue down this
path. If it does, I can't even imagine where we will be
in another 10 or 20 years, and frankly, I don't want
to imagine it. We (citizens, doctors, politicians, and those at insurance companies) need to strive for
perfection when it comes to healthcare, ensuring that
everyone gets treated in a prompt, courteous, safe,
and effective manner. Let's hope that this is the start
of a better healthcare system.

Andrew D.

Aug. 06 2007 01:57 PM
Paul Ross from Manhattan

When I lost my job in December, I continued my coverage under COBRA, provided by Ceridian Services. United Health Care took over 6 months to record that I was still covered, and all that time I couldn't get health care.

During those 6 months, Ceridian said they told UHC I was current with my premiums. UHC phone reps said their records showed my coverage ended in Dec. UHC reps would not permit me to talk to a supervisor. Ceridian said they would not call UHC, even though UHC was ignoring thei emails that I was current. I was in a Catch 22. Who was going to help me break the logjam?

At least when I was employed, I could go to my HR department and they would go to bat for me with their special contacts within the giant bureaucracies.

Any privatized health care system will need an ombudsman to fill this role.

Aug. 06 2007 01:54 PM
Claud from New York

The US has more than enough money to create universal health care, we just prefer wasting it on weapons.

From yesterday's ny times:
"The Defense Department cannot account for 190,000 weapons, including more than 110,000 AK-47 rifles, issued to Iraqi security forces..."

It's a difficult and painful fact for most people to get their heads around: our country places a greater priority on developing more effective methods of killing and maiming people than on healing them. We will not see better healthcare until people start taking active steps to changing this reality.

Aug. 06 2007 01:53 PM
Ana from North Arlington NJ

How about the fact that in this country everybody has the right to sue a doctor for malpractice and that is costing a lot of money on doctor's insurance which ends up costing us more and for that reason the insurance company that we are given .... How do you do??

Aug. 06 2007 01:49 PM
Fred from Princeton NJ

Until recently I was a contract employee in IT. Although I had a group health insurance policy thorough my job shop, I knew several other contractors who had to buy their own coverage ... they hat to pay several times what I was paying. I don't think that buying individual policies will translate into cost savings the way it might for something less essential such as auto insurance.
Just an observation.

Aug. 06 2007 01:49 PM
nataline from Harlem new york

Where is the initial $10,000 to come from. The practical: the cost of insurance is high, the average middle-income person does not have the $$ to buy and wait for a deduction on your taxes. How is it the government cannot bring down the ridiculous cost, drugs, test, hospital stay, dr. visit all cost to much, med malpractice insurance all add to the bottom line -

Aug. 06 2007 01:46 PM
Lara from union square

What does your guest think of John Edwards' healthcare proposal?

Aug. 06 2007 01:46 PM
Jon Pope from Hewitt, NJ

300 million people live in America. How many people live in Switzerland? What other overall health care system in the world comes even remotely close to insuring 300 million people?

Aug. 06 2007 01:46 PM
anonymousbrooklynperson from Brooklyn

Quote: "I'm a lawyer and my clients all have to pay cash for my services. As such, the market forces tell me what I can charge---what the market will bear. If I'm too expensive, there are enough lawyers around willing to do it for cheaper. Why can't doctors compete on price? Flood the market with physicians and then let them compete for patients on, among other factors, price. This would drive down the prices."

This would be a disaster. People don't have much control over whether they develop a chronic or life-threatening illness. In fact, everyone becomes ill at some point as they age. This "free market" approach would put the most vulnerable people - the ill and aged - in a very dangerous position. In my opinion it is inhumane.

Aug. 06 2007 01:39 PM
Moshe from Newark

I'm a lawyer and my clients all have to pay cash for my services. As such, the market forces tell me what I can charge---what the market will bear. If I'm too expensive, there are enough lawyers around willing to do it for cheaper. Why can't doctors compete on price? Flood the market with physicians and then let them compete for patients on, among other factors, price. This would drive down the prices.

Aug. 06 2007 01:34 PM
hjs from NYC

why do western europeans live longer than americans, unless their health care system is better.

Aug. 06 2007 01:32 PM
eCAHNomics from nyc

Ms. Herzlinger lacks a fundamental understanding of the economic power of the medical industry, and therefore her prescription is useless. What gives the industry economic power is the knowledge gap between buyer & seller. Augmenting that already remarkable power is the fact that the customer is vulnerable (sick). I call this combination the mafia of the intelligentsia (lawyers & higher ed are the other two industries described by this structure). One might hypothesize that increasing the customer's knowledge might reduce the power of the industry, but, of course, the economic incentive is AGAINST the industry doing any such thing.

WRT which particular parts of the industry (docs, nurses, hospitals, insurance cos, etc.) benefit, that depends on intraindustry power plays and not on anything that would be determined by "markets." The sure loser, of course, is the consumer.

Aug. 06 2007 09:42 AM

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