The key tradeoff in healthcare reform: longer wait lists
The latest round of healthcare reform is about to kick off, with Obama hoping to bring the legislation up for a vote in the fall. Paul Krugman launches his opening salvo today, telling us matter-of-factly, “Don’t trust the insurance industry.”
He argues that “we need a serious, real public option to keep the insurance companies honest.” At the same time he appears to concede the need to retain private healthcare options.
I think one of the biggest tradeoffs between the current and proposed system has not been discussed at length, and is ignored by Krugman: the incredibly long waitlists that will result if we socialize healthcare.
In other words: even if we introduce a public health system and retain private healthcare, those with private healthcare will still be profoundly affected in the form of much longer waits at the doctor’s office.
This is a positive statement, not a normative one. The debate we should be having is whether it is legitimate to make those who can pay for healthcare wait in line behind those who currently cannot.
Don’t just take my word for it; the evidence bears this out. In Massachussetts, touted as the model for healthcare reform, patients are seeing much longer waits at the doctors office. Similarly in Britain, which has socialized medicine, “long wait lists for treatment…are endemic and rationing pervades the system.”
What does this mean for you?
It means if you currently have healthcare and sprain your knee in a weekend basketball game, you can’t go straight to the MRI clinic to get it checked - you’ll have to wait a week or two, by which time it may be too late.
It means if your parents have healthcare and urgently need a kidney transplant or surgery to stay alive, they’ll be placed in be placed in line behind scores of other people who currently cannot pay for healthcare. They may die waiting for care.
Those who currently do not have healthcare will be more healthy. Those who currently have healthcare will actually be less healthy.
This is the tradeoff we face, and we should have an honest discussion about it. A legitimate argument is to say that nobody should be privileged above anyone else in terms of surgical or healthcare needs, but that does go against a part of the American mentality that if I work hard and earn money, it’s so that I can ensure that I get exactly this kind of healthcare that I want and need.
And it’s the middle class that will be hurt most by this, because the upper class will always be able to go to ultra-premium doctors and get the immediate care they need. The middle class, which goes to their local doctor and local hospital, will be stuck waiting on those lines.
This is the debate we should be having; this is the tradeoff we should confront. Op-eds that cry “don’t trust the insurance industry” while obfuscating the real issues at hand do little to advance the debate.
