When President Obama posed the above question during his reply to the first question in his press conference tonight, I listened carefully during the rest of the press conference for his answer. I didn’t hear it. Or if I did, it didn’t come through clearly enough for me to understand it.
I did hear something about more efficiency in using information systems and technology. I also heard something about not performing unnecessary tests that don’t make people any healthier. I’m a strong believer in the economies that can be achieved using appropriate technology along with Problem Solving Pattern Management, so I do believe that the kinds of things hinted at by the President can save some money, provided we approach them with good conceptual approaches. However, I’m not sure that introducing changes of this kind will save us that $6,000 the President is talking about. Certainly, I don’t think that other nations have saved that $6,000 by being so much better than we at implementing hospital IT systems, or by being so much better than we at not doing unnecessary tests (though probably some of this last is certainly involved).
In short, I don’t think our neighbors are paying less primarily because of factors like these. But I think the main factor involved is no secret in the health care community. Specifically, it is that other western nations with top quality health care systems haven’t incurred those extra costs because they’ve squeezed the private sector profits out of the health insurance system. In these countries, health insurance is either a single payer system, or where it is not, health care profits are either strictly regulated or the insurance entities are non-profit organizations. Unfortunately, it is not part of any of the plans now “on the table” in the Congress to change our system so that profits from health care are either very low, or a thing of the past, and overhead costs are minimized.
In theory, a public health option plan could squeeze out profits and excessive costs by competing in a market place with private plans and forcing them to cut profits to the bone, and also to reduce overhead (such as excessive executive compensation). However, none of the public option plans “on the table” in Congress seems robust enough to do that. So, any cost cutting that may possibly arise as result of the plan probably won’t come out of these really big ticket items and it is hard to see how we’ll be able to buy that “car” for $6,000 less.
In short, I think the President’s press conference made his concerns about the health care problem and also his goals and objectives clear. But what his plan would do to shave $6,000 off the price of that “car” is still far from clear. Until it is, I think the President will continue to lose support on the health care issue. And perhaps this may be why he was a little “flat” tonight. Perhaps he senses that he really didn’t provide a clear answer to his question, and that such an answer would at least require him to commit in no uncertain terms to an extremely robust public option, if not to single payer itself.