Health Care: Why Problems Have Piled Up Unsolved

In an amusing comment on health care, Jonathan Rauch (via Marginal Revolution) imagines an airline system as archaic and inefficient as our health care system.

“Cynthia, I have filled out my travel history half a dozen times already this year. I’ve told six different airlines that I flew to Detroit twice and Houston once. Every time I fly, I answer the same battery of questions. At least a dozen airlines have my travel history. Why don’t you get it from them?”

“We have no way we could do that. We do not have access to other companies’ records, and our personnel have our own system for collecting travel history.”

The health care system, in other words, is full of problems that have built up unsolved. Solutions exist — the problems are not impossible — but haven’t been implemented. Jane Jacobs’s great point, in The Economy of Cities, is that this is what happens when those who benefit from the status quo have too much power relative to those who benefit from change. The stagnation in American health care is profound. It isn’t solved by universal health insurance. There would remain the horrible dependence on expensive dangerous drugs that don’t work very well (e.g., antidepressants, Accutane) and the complete lack of interest in prevention. The underlying problem, the source of many visible problems, is too little innovation.

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