Mar 04, 2012 at 9:41 pm
First, whatever you read today, read this. It’s a pitch-perfect discussion by an honest, self-effacing man trying to do the best he can in a very tough job: teaching students with learning disabilities. The piece thoroughly captures the challenges he faces in a system that provides more arbitrary scrutiny than support.
I live in a world where education policy is debated from 40,000 feet up with declarations about how we must test, measure, and evaluate our way forward, with little actual consideration about dwindling resources, the challenges many kids bring with them to school, and the difficulty, if not impossibility, of evaluating teachers by their students’ test scores in this environment. This short piece brings those points to life in a way that I found extremely resonant.
Second, Ezra Klein provides some excellent analysis of why we spend so much more than other advanced nations on health care. It’s because our prices are so much higher. And why’s that?
As I’ve always stressed in these pages, it’s because health care is not a normal market and therefore, normal price setting mechanisms don’t work, a key insight that every other advanced nation embeds in their health care payment and delivery systems. Reform discussions in this area can get pretty arcane pretty quickly, but IMHO, all you need to know is that if someone shows up sick at the hospital, we treat them. Therein lies the difference…if hungry people showed up at the super market and got fed, the market for food would be different too.
Health care is an unusual product in that it is difficult, and sometimes impossible, for the customer to say “no.” In certain cases, the customer is passed out, or otherwise incapable of making decisions about her care, and the decisions are made by providers whose mandate is, correctly, to save lives rather than money.
In other cases, there is more time for loved ones to consider costs, but little emotional space to do so — no one wants to think there was something more they could have done to save their parent or child. It is not like buying a television, where you can easily comparison shop and walk out of the store, and even forgo the purchase if it’s too expensive. And imagine what you would pay for a television if the salesmen at Best Buy knew that you couldn’t leave without making a purchase.
“In my view, health is a business in the United States in quite a different way than it is elsewhere,” says Tom Sackville, who served in Margaret Thatcher’s government and now directs the IFHP. “It’s very much something people make money out of. There isn’t too much embarrassment about that compared to Europe and elsewhere.”
The result is that, unlike in other countries, sellers of health-care services in America have considerable power to set prices, and so they set them quite high.
Third, don’t forget the funnies (I like the “breeding program” panel).
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