There’s a disturbing question to ponder this evening. We’re not talking about the Lambada of health care questions here, (The “BC” words) but simply general access health coverage. Is the entire freight train of health insurance mixed in with employers, employees and Uncle Sam on a collision course with destiny which will leave us nowhere to go but the route of Canada and the UK?
It just might be, and the spur driving this particular horse may turn out to be something as nifty sounding as a $1,000 genetic map available for anyone. James Joyner explains why this could be the beginning of the end.
I’ve argued for years that the combination of unsustainability high growth in health care costs and the enormous competitive disadvantage that puts on American business means that our current system of quasi-private, insurance-based medicine will collapse of its own weight. Like it or not–and I mostly don’t–Americans will wind up with some sort of government-centric model, likely one that provides basic coverage at a fixed price with some option for private supplemental coverage for those who can afford it…
My guess is that the big driver in forcing change in the US will be from the right, not the left. That is, big business is going to start lobbying hard to get out from under the crushing burden of having to finance health coverage for their employees. Since no other major country operates their healthcare system that way, it’s a major competitive disadvantage.
One of the harbingers here is the aforementioned, affordable genetic mapping technology. Here’s how it breaks down: if the technology is advancing to the point where genetic mapping will let young people know which diseases they are most prone to and which they are unlikely to face, they would obviously shop for tailored plans which only cover them for the high risk areas. This robs the pools of people paying premiums and limits it largely to those who would likely be draining the most benefits out of the risk pool.
Combine that with already extant legislation which forbids American insurance companies from denying coverage or raising rates on those showing such a predisposition to illness, and you’ve got a recipe for insurance companies not being able to afford the costs of group plans. None of this changes the fact that health care costs continue to rise as the ability of people o pay higher premiums out of their wages fails to keep pace. This version of the future holds that the only way to artificially drive down the costs is for the government to essentially take over the industry and dictate what doctors will be paid and what medicines and procedures will cost. Welcome to your new industrial nightmare.
But is that really the only path in the new world of advanced genetics? It seems to me that there was supposed to be another side to this whole Project Genome thing, wasn’t there? I thought that once we’d mapped everyone’s genetic structure we would be identifying flaws and not just predicting what diseases they might get, but also become able to cure them, if not stop the malady from taking hold in the first place.
Wasn’t that the idea?