Sorry, it just sounds like a crazy idea for me :)...

Sorry, it just sounds like a crazy idea for me :)...

However, if anyone can come up with a way of restraining the trajectory of healthcare expenses with neither fiat pricing nor an increase in the supply of healthcare while increasing the demand for healthcare, I'm all ears.

Why must we increase the demand for healthcare? More specifically, why must we increase the demand for healthcare providers?

As underground pointed out, sometimes being an informed patient is better medicine that 100 doctors. If we can increase the general medical knowledge of the average citizen by 100%, that would do more for our system than increasing the number of doctors by 100%.

How about adding basic medical skills to the list of life-skills classes taught in High School? I learned CPR in High School, but not the difference between allergies and a sinus infection, or the common cold. How many people will see their doctor today, only to be told it's just allergies? How many will have a common cold, and will get put on antibiotics anyway, even though they are useless for a cold?

Somewhat tangentially referred to in the previous comment, but I'll state it explicitly: there's a very high chance that increasing the supply of doctors would result in more medicine being practiced, and not necessarily at a lower price. People don't have, nor have they ever had, enough ability to be able to tell when a doctor is recommending something necessary or something optional which might help in 1 out of 100 patients but will definitely help 100 out of 100 doctors.

I think that's probably right if we increase the number of doctors being graduated by 10%. I'm not sure it's as true if we increase the number of doctors being graduated by 100%.

Plus there are more ways of increasing the supply of healthcare than increasing the number of doctors.

However, if anyone can come up with a way of restraining the trajectory of healthcare expenses with neither fiat pricing nor an increase in the supply of healthcare while increasing the demand for healthcare, I'm all ears.

http://www.nytimes.com/2007/11/04/business/04view.html?pagewanted=all

It's worth the read to be fully informed.

So far as the claim that a government controlled, single-payer system will reduce cost and increase quality, which is not covered in Mankiw’s article, that’s not an assumption born out of experience. An historical review of similar claims and attempts to do the same reveals enormous waste and fraud whenever it's been attempted, for no gain or improvement, eventually leading back to privatization of the industries under government control. The most recent example would be the airline industry. One can also point at organizations such as NASA and certain aspects of the military. In every instance when the government took control, quality plummeted while costs soared, with most of the money going to the bureaucracy. Health care would be no different and probably would be irreparably damaged in the process.

The solution will probably be a national, single-payer health plan for all Americans at the most basic level, blended with tax incentives to promote widespread use of information technology in health care, as well as tax incentives to enable most Americans to purchase private health coverage beyond the most basic coverage. This is a cooperative, symbiotic approach to covering all Americans that will probably work if our politicians ever give up on the power grab going on today and do what’s best for the people of this country.

Mike McBride

There is an issue that people aren't covered, but I can also attest through personal experience that the system has a problem even if you're covered and have plenty of cash (simply extending universal coverage won't fix these issues, only reward doctors/pharmaceutical/insurance companies.) Through surgeries, prescriptions, and a dozen specialists I remained undiagnosed with Celiac Disease for more than ten years. There are literally millions of Americans dying early and at risk for diabetes, cancer, and auto-immune diseases because of Celiac, yet its only diagnosed properly 3% of the time after an average delay of eleven years.

Why? I have no idea, but is it a coincidence that there's no pharmaceutical cure for the condition that goes undiagnosed? They had no problem implying IBS, CFS, anxiety or anything that is treated perpetually with a popular pill, but they never once mentioned Celiac. I only found out about it later from an art teacher who had met people struggling with my same set of symptoms.

Now, ironically, I haven't used my insurance in years and I'm in the best health of my life. I wish I had a political/structural solution but for me the answer has been proper diet, exercise, and being an informed medical consumer. Doctors don't like it when you research your own symptoms, but I think its very important to stay involved and aware.

But a single-payer system is no panacea for the cost problem — witness Medicare’s own cost troubles — and the approach has limited political support.

This happens at both the federal and state levels. My sister in law went to med school in Ohio, and they picked up her med school tab as long as she stayed in the state of Ohio for five years after completing her residency program. Although I think that program is for any kind of specialty, because she is a general surgeon, not a primary care physician.

But these programs exist, I just wonder if some of them aren't pinpointing the right specialties.

I do know another big constriction point isn't so much the med schools themselves but the number of available residency slots available. Not sure exactly where the funding comes from for the various slots, but if the feds wanted to get involved funding primary care residency programs might be money well spent.

The editorial mentions that many dems really want a single-payer system, and then they list three reasons why such a system would save a lot of money - "...would let the government offset the price-setting strength of the medical and pharmaceutical industries, eliminate much of the waste due to a multiplicity of private insurance plans, and greatly cut administrative costs".

How could you possibly claim that their conclusion was that this "may not do much to reduce costs at all."

They did say that it was not a panacea - whatever that means.

It does seem to me that in addition to the mechanisms for savings listed above, such a system offers the best handle by which to reduce costs in the other ways that they discuss.

It would also seem prudent for the feds to pay tuition for those med students willing to serve as primary-care physicians in needful locations; some of this goes on now, I believe, but increasing the scope of the program might help.