My two favorite wonky podcasts have recently done episodes on healthcare (The Weeds, Common Sense) and the takeaway is this:
1) Americans pay a ton of money for healthcare and we don't get very good results-- we may be the greatest country in the world for lakes, but we are not even in the ballpark when it comes to health outcomes-- not only do we pay more, but we get less, and-- most significantly-- for a developed country, we die rather young;
2) we have taken the worst aspects of free markets and government subsidized healthcare and combined them, and at every step of the way, players are trying to squeeze profits from the system-- and without the government to negotiate prices, the patient is screwed;
3) Republicans care more about giving a tax break to rich people than actually reforming the system;
4) we may be subsidizing medical innovations for the rest of the world with our high drug costs . . . or that's what people who work in the industry would like you to believe;
and Dave's theory is this:
it all comes down to what William Gibson said: "the future is here-- it's just not evenly distributed," and how America decides to apply this sentiment to the population, as there's plenty of incredible medical advances, knowledge, drugs, and treatments and if we distributed these to the majority of Americans, we'd have a much healthier country . . . or you could take the Paul Ryan route and try to make the distribution as lumpy and uneven as possible, which might save money, or might allow for some advances for certain people, but wouldn't give everyone access to the future that is already here . . . and it seems that the disagreement over Gibson's idea breaks down along party lines; I know I'd rather have everyone getting access to all we have available now, even if that meant there wouldn't be as many innovations in the future, especially if you could decouple health care from employment and allow people to move around the country and switch careers without fear of losing benefits, as that would really spur the economy (as would a healthier populace) and maybe convince a few folks that coal mining is the only way to make a living (despite the particulate matter and mercury poisoning, which are quite costly, from both an environmental and healthcare perspective) but there are plenty of people-- rich people, conservative people, lobbyists, people in the medical business-- that would like to see things continue as they are, or even get less evenly distributed and make the industry more about economics and free markets . . . but the important thing to remember is that good health is a temporary state, no matter how well you feel, the reaper's scythe will cut you down to size soon enough . . . cheers!