30 Jan When will runs into the capacity wall
Things are interesting in D.C. as they consider a new approach to “health insurance.” A philosophical shift is afoot – A move from federal control and determination to one likely rooted in the states. While this has the potential to afford greater flexibility and innovation – economic realities remain. While the desire to provider “coverage” for as many as possible likely remains, the ability to finesse this given the financial realities are significant. It remains to be seen whether the GOP-led administration has sufficient political capital to make tradeoffs between coverage and government financial burden. It is impossible to provide unlimited healthcare to all Americans. We cannot technically exact such a wealth transfer even if the will was present. In my humble opinion, we are beginning a conversation regarding realistic tradeoffs which will likely put us on a path similar to all other advanced economies whereby the government defines a set of services as the base available to all, and those with the financial capacity buy up for greater access and services. This is the real issue, one we have ignored in the U.S. and if engaged honestly will bring to the forefront a tiered healthcare system much like what exists around the world. The question is whether we have the cultural will and capacity to have such an honest conversation. Given the discourse in our country over the weekend I have my doubts.
Larry Van Horn