Socialized Medicine is a good idea...

[Linette]

...according to James Kroeger

From his June 17 blog entry Universal Health Care:

"...I tend to think it is far more important that Democrats determine which kind of idealized health care system they would bring into existence if they could, giving special attention to the key principles upon which they would base their ultimate choice."

"This discussion reminds me a lot of the “Economics of Health Care” course I took in graduate school, possibly the most enlightening economics elective I ever took. It was the term paper in particular that I found especially challenging. We were asked to “solve” the health care crisis in America, given all that we had learned about America’s health care industry and the comparative health care systems found in Canada, England, France, Germany, and Japan. The model I ended up embracing was certainly not one that I had originally thought might be among the final two contenders."

"...What led me to my ultimate choice was discovering that there were a couple of fundamental principles I could logically base my choice on. Indeed, I eventually realized that there was one principle above all others that Democrats should be basing all of their reform proposals on. We need to fix the incentives that drive our health care providers...

"...Total health care costs were being “brought under control”, but they were only being limited through a reduction in the quality of health care being received. Seeing this evolution in the incentives of America’s health care providers focused my attention on the need to create a system that gives primary care providers the right kind of incentives. How might it be possible to set up a health care system that gives providers a natural incentive to give patients the best care possible while not also tempting them with financial incentives to over-prescribe care? The answer is to put doctors on a salary."

"If a physician gets paid a generous salary for “just being a doctor”, for “doing what a doctor does” then she will not receive any extra revenue if she prescribes extra tests & procedures. Nor will she be rewarded financially for under-prescribing care. When physicians are on salary, they are freed from their concerns about financial matters and are able to fully invest themselves in the most idealistic inspirations of their calling. They can simply focus on healing people and not worry about all of the administrative crap."

"Once it became clear to me that incentives should matter more than any other variable when Americans are discussing health care reform, I was led by logic to the “Socialized Medicine” model that Great Britain has embraced for over 50 years. In spite of the bad press that the National Health Service has received in this country (by the same people who give bad press to Democrats & Liberals) it has actually proven itself to be perhaps the most efficient provider of health care in the free world..."

"...Perhaps the best long-run strategy is to try to win over the doctors, first. Tell them that we’ll freeze their current average salary (in different markets) and then take all of the “non-medicine” burdens off of their shoulders. Then, with hopefully the support of a majority of physicians, we could take on the insurance industry, perhaps proposing an AMTRAK-type of transition to them. The pharmaceutical industry may be the most guilty of running up our health care costs, but it may be best to take them on last..."

I left out the parts where he provides links to published data. I really don't know how it's possible to disagree with him about the incentives. Anybody?