10 EXPERTS OR 400 MILLION CONSUMERS?:

New Efficiencies in Health Care? Not Likely: If the British experience is any indication, generic drugs and expert commissions will do little to lower costs (THEODORE DALRYMPLE, 4/16/11, WSJ)

All attempts to reduce bureaucracy increase it, and the same goes for cost. Such, at any rate, has been my experience of the British health care system—its famed, or infamous, National Health Service.

Thus, I could not but smile a little wanly when President Barack Obama said this week that he hoped an increase in the use of generic drugs, together with an expert commission to examine the cost-effectiveness of medical treatments, would make a significant impact on the vast budget deficit of the United States. We in Britain have been there and we have done that, and our health-care costs doubled, perhaps not as a result, but certainly at the same time.

The best that might be said for these measures is that the increase in health-care costs was lower than it might otherwise have been. That is certainly not enough to save a country from a financial apocalypse, or even enough to be a major contribution to its salvation. [...]

It is an occupational hazard for politicians to think that they and their ilk know best, and by all indications Mr. Obama rather likes centralization. In my professional lifetime in the centralized British health-care system, however, I have seen a hundred schemes of cost reduction, but I have never seen any reduction in costs, or at least any that lasted more than a few months. I can't remember a single health minister who did not promise more efficiency at less cost, or a single one who actually managed to achieve it.

The long-term solution, I imagine, is the same for health care as it is for pensions: to pay for it with the income generated by dedicated savings accounts, which can be transferred to the next generation after death. The important thing is to reduce the insurance element, which encourages a pay-as-you-go system, a kind of Madoff scheme ensnaring the whole country.

If we are to have health-care systems that don't bankrupt us, people will have to accept paying more bills out of pocket and perhaps lowering their standard of living. Tiresome as the advice might be, we had better start saving a good deal more.

Only health savings accounts get us where we're going; we're just bickering over the pace of reform.

Posted by oj at April 17, 2011 7:18 AM
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