March 14, 2009

the health insurance debate

There is so much dialogue on the issue of health insurance coverage, on FB, the blogosphere, tweetscape, news. Everyone has an opinion on the best system (popular option seems to be single-payer) and so much energy is batted around the design of a universal scheme.

What I want to see is a growing dialogue on the root issue, which is the big pharma-medical financial incentives megastructure. From the agriculture policy to who funds continuing medical education to lobbying heft on the Hill, there is NO ONE AREA of lifestyle NOT touched by this monied interest. Look around, do some research, and you will find that even the most innocuous facets of life and decisions made is heavily if not directly influenced by Big Pharma.

Those who insist that there are laudable national health insurance designs in France, Scandinavian countries, and Japan (or elsewhere beyond the top 3 in coverage schemes) must look at the books. Populations in these universal coverage programmes are ageing, expecting more high-tech innovations in care, demanding more options and access. These lead to increased financial liabilities to the health system. They are all to one extent or another unsustainable in their current form in the long run. And that is with regulation in place for big pharma much more stringent and patient-focused than we have in the US.

Dialogue--and legislative action-- has been taken up in these oft-cited "model" countries on how to make access to health and medical care affordable without bankrupting the system. There needs to be a sound legislative and policy framework before we can talk about coverage and financing designs.

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