This week President Bush has sketched out his broad vision of an "ownership society." This is code for a broad attack on many of the social programs in the US including Social Security, Welfare, Medicare and Public Education. In this week's New England Journal of Medicine, US Senator William Frist applies this vision to health care with the concept of "Consumer Driven Health Care". I am attaching a notation from the list-serve of the Physicians for a National Health Program (www.pnhp.org).

I think it is important for our non-US friends to see the direction the ideological winds are blowing here.

Best,
Matt Anderson
www.socialmedicine.org

The New England Journal of Medicine
January 20, 2005
Health Care in the 21st Century
By William H. Frist, M.D.

Consumer-Driven Health Care

The new system also must be responsive primarily to individual consumers,
rather than to third-party payers. Most health care today is paid for and
controlled by third parties, such as the government, insurers, and
employers. A consumer-driven system will empower all people - if they so
choose - to make decisions that will directly affect the most fundamental
and intimate aspect of their life - their own health. This empowerment gives
people a greater stake in, and more responsibility for, their own health
care. Health care will not improve in a sustained and substantial way until
consumers drive it.

Affordable Health Coverage for All Americans

Tax-free health savings accounts (HSAs), adopted in 2003 as part of the
Medicare Modernization Act (Public Law 108-173), will help speed the
movement to a more consumer-driven health care market. It is estimated that
half of all employers will offer HSAs to their employees within the next two
to five years. HSAs, coupled with affordable high-deductible insurance
policies, give individual consumers more control over their health care
choices and hard-earned dollars. HSAs give people a greater stake in their
own health care.

Conclusions

American health care is at a crossroads. Rapidly advancing forms of
technology are dramatically improving lives. Simultaneously, U.S. citizens
face enormous inefficiencies, escalating costs, uneven quality, disparities
in health care, and rising numbers of uninsured people. For decades,
policymakers have debated and rejected a variety of solutions. What we have
never done in the health care economy, however, is foster the kind of
competition that has made other industries the most successful, prosperous,
and advanced in the world.

http://content.nejm.org/cgi/content/full/352/3/267

Comment: Sen. Frist uses rhetoric that makes every free market enthusiast's
heart pound with sheer joy. But those who understand the current policies
that have resulted in our extravagantly expensive but perilously
underperforming health care system, also understand the policies behind Sen.
Frist's rhetoric. Not only is he implicitly supporting financial hardship
and personal bankruptcy, but, worse, he is supporting policies that can only
increase suffering and death.

Tragically, Dr. Frist is allowing political ideology to trump beneficial
health policy. It is difficult to reconcile this with his role as a
colleague in the healing arts.

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