After hearing about 800 million mentions of “healthcare reform” in the past couple of months, this weekend I visited my normal (not-HC-geek) family in Maryland for Mom’s 80th birthday.  (Woohoo! Large clan descends, six siblings and most of the grandlings.)

Inevitably the subject of reform came up, and I realized not everyone is aware of the discussion. And of those who are, not everyone is sure what the heck they’re all talking about. What do you think they’re talking about on Capitol Hill?  Is it:

  • Making sure everyone has insurance? (20% of Americans don’t.)
  • Lowering costs? (Per capita, US healthcare is about 50% more expensive than other developed nations.)
  • Making sure everyone can get good care in a crisis?
  • Lowering costs? (Per capita, US healthcare is about 50% more expensive than other developed nations.)
  • Improving outcomes? (Everyone around here has heard that the World Health Organization ranks the US 39th.  And, btw, yesterday I heard that the life expectancy of an American with depression or bipolar is the same as your average citizen of Bangladesh.)
  • Other?

No fair saying “All of the above.” We’d have enough of a challenge accomplishing any one of those, let alone any two or three. My question is, what do you think they’re arguing about (and failing to achieve)?

Of course, there’s also what they should be aiming for. But for the moment I’ll settle for what they are trying to do.

It drives me nuts when I hear people say “Who’s going to pay for all this??” Any competent manager in any lean industry would look at the second bullet above (50% excess cost) and the first (20% have no coverage) and would see that removing just some of the bloat would easily care for it.

So I really wonder, what are they talking about?

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