If I were to affix an epigraph to my space on this blog, it would be this, courtesy of Princeton University health economist and raconteur Uwe Reinhardt:
"Every Dollar Health Spending = Someone's Health-Care Income"
Reinhardt calls this the "Alfred E. Neuman's Cosmic Health Care Equation" (which is probably some sort of Princetonian inside joke).
Is it a little obvious? Maybe, but only in the sense that the obvious is frequently taken for granted and carelessly forgotten.
Every would-be health reformer from the Cato Institute's free-marketeers to Physicians for a National Health Program's socialized-medicine agitators agrees on one thing: Health care costs too much, so we should find ways to pay less for it. This is a laudable goal from a consumer standpoint and good fiscal policy to boot.
What gets lost in the shuffle, Reinhardt reminds us, is that all of that "overspending" ends up in somebody's pocket. And that somebody ardently wants to keep it there while they go about collecting more. It's a natural instinct. It's also what's going to drive millions of dollars of lobbying on health reform by the businesses on the right side of Reinhardt's equation.
When the average person hears politicians, academics, activists, etc., talk about health reform, they ask themselves, "How is this going to affect me?"
Back in the 1990s, Harry and Louise, the health insurance industry's stand-ins for everyday folks, thought Bill Clinton was going to take away their doctor and hand over their medical care to pencil-pushing civil servants. They may look differently on Obama's plans. Harry and Louise themselves seem more open-minded these days.
Those in business of healthcare ask the same question but, by virtue of how they earn their money, they are more conscious of the principle underlying Alfred E. Neuman's Cosmic Health Care Equation.
Anyone observing or participating the political process of re-making the health care system ought to be conscious of it, too, and be honest about and accepting of the fact that wholesale changes to how we deliver and pay for health care, by definition, are going to reduce someone's income.
Jeffrey Young is a staff writer at The Hill.