Picking up on my last post:

You do what you do because you like doing it. Because you like doing it you do it well. Because you do it well, it's valuable to other people.

In a clinical analysis, there's no real need for thankless labor anymore, though with our industreal-era habit of massive over-consumption quite a bit of it still exists. As a society we're trapped in a dead-end way of thinking, but the current People In Charge are deadly afraid of allowing different ideas to be taken seriously. Such an undertaking, while perhaps getting closer to the truth, might jeopardize their position.

An example: in my previous post on health care, my friend A-Stock (also named Alex, but another friend named Alex already commented) wonders how a better system might come into being. My other friend Nick responds in girthly fashion and is, I think, essentially correct. But I want to kind of elaborate on what's going on here.

First of all, the question of paradigm. In response to the observation that Americans spent more than twice per-citizen on health care as any other nation in the world, yet still manage to have middling life expectancy and close to 50 million citizens with no coverage, Alex asks "How do you pay for [health care for more people]?"

The answer is we're already paying for it. In fact, we're paying double. The question is not how does one pay to get quality health care for all citizens. The question is who do you pay.

Now, what do I suggest? I suggest we not be shy about picking up a good idea and implement a standard single-payer system for all general coverage: preventative care, dental, and anything you need to stay alive at a minimum. We can haggle over "quality of life" costs (hip replacement, viagra, etc) all day long, but covering the basics is a no-brainer and there's no reason not to do it.

I suggest we call health insurence what it is: a trickle-up system of extracting wealth from working/middle-class families and seniors. Insurance companies are out to make money, and the market doesn't have any problem using human suffering and weakness to drive profits. Remember the market doesn't give a shit about people or society. Is it right for health insurance profits to skyrocket as medical coverage declines?

I suggest we remove inefficient and corrupt profit-taking beureaucracies from health care administration as well. Medicare runs about 3% in administrative overhead. HMOs are somewhere between 4 to 15 times as wasteful. Why are we tolerating this drain on our economy?

I also suggest we allow collective bargaining with pharmaceutical companies on drug prices. To make up for any lost profits, we can prohibit marketing and doctor-lobbying for prescription medications. Free speech is not a right to advertise, and prescription medications should be recommended by doctors, not hyped directly to consumers. The US and New Zeland are the only countries that allow this practice; maybe we should rethink it. Cutting the ad budget will remove about $2.5B in costs for the pharmaceutical industry, which should provide a healthy boost to their bottom line.

To sum up, I suggest we give businesses an effective tax break and provide workers with a bigger paycheck and more peace of mind by making health care efficient and decoupling it from employment. Our immigrant population won't wreck the single-payer equation. This problem can be solved. Even if we're not as efficient as the Germans or Japanese, we can still give workers and businesses a boost to their bottom line while simultaniously providing coverage to the millions of uninsured.

In today's political environment, this is a somewhat radical ideas, but it shouldn't be. It's just the truth.

Update: J-Chow (Gotta Drop A Blog), the voice of reason:

yes, something needs to be done, but the solution is not simple because it involves a large number of people giving up power, perks, control, and money. it also involves people (the general population) becoming less apathetic and focused on others (instead of our own selves). this will be the hardest part of the process.

I too don't think the solution is simple. I think there are ways to innovate. For instance, why not have single-payer coverage for general health care with private coverage (maybe even "Health Savings Accounts") for elective and quality-of-life costs. Couple that with a redoubled investment in R&D, total transparency in accounting, and a system of oversight and governence that doesn't put CEOs, bureaucrats (corporate or government), politicians or union bosses in the drivers seat, and that's getting to sound pretty sweet. I'd settle in the short term for not having health care tied to a job, bringing down costs so give small businesses a break, and covering people who are really in pretty desperate need.