• Differences between conservatives and liberals

    After my last request for more accurate characterizations of the differences between those on the Left and Right when it comes to health care reform, I didn’t feel like I made much headway.  In yesterday’s NYT, however, Gov. Mitch Daniels (my governor, mind you), did a much better job (David Leonhardt, reporting):

    [Daniels] also thinks that people should save money when they choose less expensive Medicare treatments and lose money when they choose more expensive ones. Progressives, he said, believe in letting experts decide which treatments the government will cover. He wants individuals to decide what care they will get.

    See the difference?  No demogoguing that Liberals would refuse to allow you the care you want, no straw man arguments about denying you care you’d pay for yourself, no screams of rationing and references to the UK.  Not a death panel in sight.

    The whole article is worth a read.  I can tell you, as a resident of Indiana, that Mitch Daniels is widely respected by many people on both sides of the aisle.  He won re-election easily, even when the state went blue (briefly) to elect President Obama in 2008.

    I doubt that Gov. Daniels and I would agree on every aspect of health care reform.  For instance, I do believe in some level of experts deciding what treatments the government should cover.  I also don’t believe that consumer directed health care is the panacea many believe it to be.  But I do feel that he’s someone who would engage in rational discussions about the issue, instead of trying to mischaracterize those who disagree with him.

    We could use more people like that in this debate.

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    • We need more straight forward, non partisan characterizations and discussions like this on all topics.

    • I for one would be willing to entertain the following: When a diagnosis is made that is most likely terminal, and treatment is available to extend the life but not cure the disease, make the patient an offer:

      “Art, here is the standard treatment protocol. On average, life is extended 3.5 years through this method, and the average cost is $85,000 over the course of treatment. We’ll gladly pay for that, or if you opt for palliative care only, we’ll pay your heirs a benefit of 60% of this amount when you pass, or pay you 40% of it today to use as you will.”

      If so much of the overall expense is EOL care, spent extending quantity but often not quality of life, give people a choice…with an incentive. I’d likely avoid aggressive treatment anyway, even though I’m not yet 50; it’s just my way of looking at things. But why not share the economic benefits of such a choice? Many would rather their families have a bit more when they’re gone than that they “endure” aggressive treatment and linger for a few months or years.

    • I also don’t believe that consumer directed health care is the panacea many believe it to be.

      Of course nothing is a panacea but…

      Anecdotal evidence from my life and lives of friends shows that when we have told our doctors that we are paying directly they change the course of care significantly. I once had a doctor come to me and tell that he did not know that I was paying for my wife’s hospitalization or he would not have kept her nearly as long in the hospital. He then dismissed her that day. I do not know how long they would have kept her had insurance been paying. Then there are cases where they switched to generic meds and dropped tests etc. for me and freinds have told me the same thing.
      Further in the Rand health insurance the full pay group spent 40% less and the evidence was they were still spending more than optimal.
      Over time if more people were paying directly for medical care norms would change, maybe dramatically. I would not expect things to go optimal or even right, right away. At first people might consume to little health care or the wrong health care but stories of people dieing of things like untreated appendicitis etc. would tend to push norms.

    • No matter what the political pursuasion, it is ultimately all about the cost. We simply cannot put everyone into a Lexus.