Krugman on U.S. health care

Once again, the worsening labor conflict in my kids' school district really underscores for me the critical need to deal with the national health care fiasco. So this recent Krugman article really struck a chord with me: Pride, Prejudice, Insurance(TimesSelect article, sorry):

Why does American medicine cost so much yet achieve so little? Unlike other advanced countries, we treat access to health care as a privilege rather than a right. And this attitude turns out to be inefficient as well as cruel.

The U.S. system is much more bureaucratic, with much higher administrative costs, than those of other countries, because private insurers and other players work hard at trying not to pay for medical care. And our fragmented system is unable to bargain with drug companies and other suppliers for lower prices.

Employment-based health insurance is the only serious source of coverage for Americans too young to receive Medicare and insufficiently destitute to receive Medicaid, but it's an institution in decline. Between 2000 and 2004 the number of Americans under 65 rose by 10 million. Yet the number of nonelderly Americans covered by employment-based insurance fell by 4.9 million.

The funny thing is that the solution - national health insurance, available to everyone - is obvious. But to see the obvious we'll have to overcome pride - the unwarranted belief that America has nothing to learn from other countries - and prejudice - the equally unwarranted belief, driven by ideology, that private insurance is more efficient than public insurance.

It's so hard to imagine any current politician having the guts, the vision, and the power to move this issue forward. But it is possible to imagine lots of major, disruptive changes in the near future. Who knows when the door will open. Hopefully soon.