The other day the San Francisco Chronicle carried an article by their Washington correspondent in which a number of economists speculated that, for the first time, it seems reasonably possible that the United States Government is headed for a financial meltdown of the type we are used to seeing in Latin America or East Asia.
The culprit? There are many to choose from, including the mortgage debacle, spiraling food and fuel prices, and uncontrolled war spending. But the one large, immovable object that the experts all mentioned was healthcare – $2.4 trillion this year alone, over $1 trillion in direct government spending.
Here's what caught my eye: The experts queried could only think of two ideas on what could be done about healthcare costs: cutbacks and rationing. Among the mainstream economists of the United States, there is little (if any) discussion of the idea that there might be anything about the structure of healthcare in this country – who gets paid for what, on the basis of what information – that makes it cost so much more than any other country's. There is little discussion of alternative models, of whether our system has developed ill-deployed excess capacity, of whether having nobody in charge, and no internal feedback based on real value to the customer, is a good idea.