• Add this to things that sound great, but aren't

    As with obesity, health care costs are a complicated problem.  If the fix were simple, we would have done it a long time ago.  But that doesn’t seem to stop candidates for major office from pretending that a common sense solution exists for this enormous issue:

    Sue Lowden (R), the leading Republican Senate candidate in Nevada, recently articulated her vision of how the American health care system should work. At a local candidate forum, Lowden, a former state senator and chair of the Nevada Republican Party, encouraged Nevadans to “go ahead and barter with your doctor.” It would, she insisted, “get get prices down in a hurry.”

    Bartering would bring prices down in a hurry?  Here is her argument directly:

    “I’m telling you that this works,” the Republican candidate explained. “You know, before we all started having health care, in the olden days, our grandparents, they would bring a chicken to the doctor. They would say, ‘I’ll paint your house.’ I mean, that’s the old days of what people would do to get health care with your doctors. Doctors are very sympathetic people. I’m not backing down from that system.”

    Look, first of all, the only thing a doctor can barter for is his time.  That’s it.  I suppose a doctor could decide to take less than his usual fee (or a chicken) in exchange for his time spend in an office visit.  But a doctor can’t barter away the cost of his office.  His taxes.  His billing expenses.  The medicines, equipment, and supplies he needs.  The cost of a laboratory.  The cost of tests.  And so on.

    And that’s just an office visit.  Imagine if you needed surgery.  There are hospital bills.  Operating room fees.  Anesthesia.  Techs.  Nurses.  Drugs.  And tons of other things you never think about.  Go look at a hospital bill, and I guarantee you that the doctor’s fee is one line on a multi-page document.

    Moreover, a chicken?  Really? Maybe in the “olden days” health care costs could be counted in chickens, but no longer.  I just checked, and I can get a rotisserie chicken from Marsh for less than $5.  That’s what Sue Lowden thinks a doctor visit should cost?  I have a pretty thick skin, but that’s insulting even to me.  Maybe we can pay her Senate salary in chickens.

    I’m hoping that, in her own way, she is trying to make the argument that exposing consumers to prices and forcing them to be discriminating shoppers could help to contain costs. My fear, though, is that she really means what she says.

    Health care reform is incredibly complicated, with difficult choices and significant trade-offs.  Sound bites and solutions involving chickens are not going to help.

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