I for one remained baffled about what’s happening within the gizzards of the Grey Lady. On Sunday the NY Times published presented a long editorial about American health care and its high costs.
After the dog sore licking episodes of last year, (hinted at in the "does this matter?" section of this editorial when they dare to say "By some measures, Americans are getting good value.") this year the NY Times has had some sensible columns and has highlighted Wennberg’s work.
The editorial is a hodge podge of mostly correct analysis without any real "editorial" as to what to do. I’m baffled. Most of us would largely agree with their diagnosis but I’m confused as to what they’re suggesting here. The final paragraph bears repeating for being total woffle
By now it should be clear that there is no silver bullet to restrain soaring health care costs. A wide range of contributing factors needs to be tackled simultaneously, with no guarantee they will have a substantial impact any time soon. In many cases we do not have enough solid information to know how to cut costs without impairing quality. So we need to get cracking on a range of solutions.
I long for the halcyon days of 1992 when the NY Times more or less supported managed competition. There are plenty of things we could do (managed competition properly implemented is one, single payer is another, extending the VA to all Americans is a third). All of those policies would do something to contain costs. Now I’m a realist and I know we’re not going to do any of those–but this piece is supposed to be an editorial, fer chrissakes! Can’t they support something?
This editorial was clearly written by a committee that either didn’t understand the solutions or doesn’t agree about them.
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There is no silver bullet but lots of silver pebbles. Some, like malpractice reform, price and quality transparency, P4P, and more widespread use of living wills, lend themselves to state level experimentation. Others, like interoperable electronic medical records, comparative effectiveness research, and subsidies to help low income people afford health insurance, probably require a national approach, national leadership, and financing by federal taxpayers.
Agreed – the Times went to the edge of the cliff, looked down, and then backed away from a big solution … just like almost everyone else responsible for implementing a “solution.”
We have to STOP looking for the single magic bullet to solve all our problems. There is none, there never was, and there never will be one. This quixotic search for a single magical cure has impeded real progress.
The Times was right — the “solution” is likely a multi-faceted. But it is not going to be interesting or sexy to the general public, presidential campaigners, or to editorial writers constrained by a 2,000 word limit.