News/Commentary
This is an objective analysis of both candidates’ positions on health care.
Short and insightful.
There are two totally different approaches to reshaping health care for the 21st century. Both candidates have to make assumptions over which they have no control, most specifically, where’s the money coming from and where can money be saved?
If this were easy, we wouldn’t be where we are today.
There is no split-it-down-the-middle solution.
Give them credit for trying. Whoever wins will have one big fight on his hands.
Which is why we are where we are today.
We have not settled on what we believe to be right, fair and achievable in health care.
Until we do, any elected official is going to find it all but impossible to get enough votes to take constructive action.
We have had so many surprises: the obesity epidemic is an example. How can we calculate savings from prevention when prevention efforts for one major risk factor, obesity, are failing on a grand scale? Thirty years later, AIDS still is with us and may not be the victory story everyone hoped for. An influenza pandemic (which refers to how many people get sick not how serious it is) is likely; the 1918 influenza epidemic killed more young adults than older ones.
We cannot predict the rate or cost of change, regardless of who is sworn in in January.
The assumptions made, for instance, about health plan participation or the adoption of electronic medical records are simply that: assumptions. There are models for making educated estimates but that’s all they are. Humans are not models and are quite unpredictable. So, there’s that.
Everybody is going to have to give up something to get this nation’s people insured, period.
So far, it is not clear who the first volunteers will be.
We should not ask our candidates to do funny math to persuade us.
Choices need to be made. Real ones.
We show no sign of being ready to do that. America is mad and scared.
Those are not the same as being ready to change.
New England Journal of Medicine
“The McCain and Obama health plans are best viewed as sketches rather than finished portraits, with many important details yet to be revealed. Still, the 2008 presidential election clearly offers voters dramatically different alternatives. The candidates’ opposing visions of health care reform reflect fundamentally different assumptions about the virtues and vices of markets and government. With the debate over how to reform U.S. health care far from settled, whoever wins the presidency can expect fierce opposition to any attempt at comprehensive reform.”
Source: New England Journal of Medicine, Volume 359:781-784, August 21 2009, Number 8. (Perspective/Free)