We generally provide the best health care in the world in the USA. Our primary failing is opening access to insurance for the working middle class whose employers don’t provide it, and to people with preexisting conditions that don’t qualify for Medicaid or Medicare (which, like all single payer systems are collapsing, but I don’t want to talk about that in this post).
Obamacare used that very real problem as a front to place nearly the entire American healthcare system under the control of the federal bureaucracy—which in my view, will seriously damage the quality of US healthcare—as it eventually breaks the bank. Thus, as I have written, federal bureaucrats can now just give goodies to favored political constituencies and make the private companies pay for it—as in the ludicrous imposition by Obamacrats imposing upon private health insurance the requirement to pay for a broad array of so-called “reproductive services” under the guise of free birth control.
But as we have seen in the UK’s NHS, such centralized bureaucratic control makes it very difficult to improve the delivery of health care. That is why I think this story is important. Our independent private sector hospitals (profit and non profit) have tremendously increased the percentage of heart attacks treated within 90 minutes, saving lives—and all without bureaucrats sitting on their shoulders telling them what to do and how to do it. From the Associated Press story:
In a spectacular turnabout, hospitals are treating almost all major heart attack patients within the recommended 90 minutes of arrival, a new study finds. Just five years ago, less than half of them got the patients’ clogged arteries opened that fast. The time it took to treat such patients plunged from a median of 96 minutes in 2005 to only 64 minutes last year, researchers found...
What is remarkable about this improvement, Krumholz said, is that it occurred without money incentives or threat of punishment. Instead, the government and a host of private groups led research on how to shorten treatment times and started campaigns to persuade hospitals that this was the right thing to do.
That kind of adroitness demonstrates the power of flexibility that centralized systems don’t possess. Bureaucrats give orders in thick, impenetrable prose and make checklists. In contrast, this success resulted from giving hospitals quality information and leaving them alone to work out how to improve their own systems. Big difference. Great result.
And this highlights a little-discussed pitfall in Obamacare. In my view, the president’s power grab will create sclerotic top-down process that will destroy flexibility and make successes like this one much more difficult to achieve.
