I reported earlier about my recent adventures with America's "best health care system in the world." I can't imagine how all the right-wing fear-mongering about rationing and long waits can possibly be effective on anyone who has actually had to use our current health care system for any actual care, because I can tell you from first hand experience that unless you are rich (and sometimes even if you are rich) we already have rationing and long waits.
My PCP (primary care physician) read my blog and ran interference for me to get me in to see the dermatologist ahead of the queue. I was told that they didn't pull and strings, that there just happened to be a cancellation the next day, but I have no way of knowing if that was actually true. They may have just been telling me that because I specifically asked them not to pull strings. Either way, the fact that I got in early can't be counted as a victory for the system. At best, I got lucky. At worst, I got bumped to the head of the queue because I can afford to pay extra for access to a PCP who has enough free time to do things like read his patients' blogs.
At the dermatologist, I learned the following:
1. I almost certainly don't have cancer, but it's not a total slam-dunk. They told me to come back in three months for a followup just to be sure.
2. I was not waiting in line behind possible melanoma cases. I was waiting in line behind dermabrasions, botox, and facial hair removal.
So I believe it's fair for me to chalk up my experience as support for those who say that the present system is at least partially broken.
IMHO, the fundamental problem is that health care is (or at least ought to be considered) infrastructure, and free markets don't do a good job at providing infrastructure. I am a born-again capitalist. I believe in free markets, not for ideological reasons, but because empirically they tend to produce a net benefit for the well-being of mankind more effectively than any other system than has yet been invented. But free markets are not without their problems, and so various degrees of government regulation are needed to keep them performing their function even under the best of circumstances. If nothing else, government is needed to enforce contracts and discourage fraud. But even then, free markets work better for some goods than for others. They are really good at producing technology, commodities, and luxury goods. They are not so good at providing infrastructure. The U.S. is currently conducting an experiment at using free markets to provide wireless communications infrastructure, and the result is cell phone service that is not only universally crappy, but five times more expensive than anywhere else in the world. By way of contrast, the Internet, interstate highways, and the (wired) phone system are all cheap and reliable, and all are the result of government intervention of one sort or another.
I think health care ought to be treated as infrastructure. It's something everyone needs sooner or later, and it has a very long lead time to produce. Our current government-run health care plans, medicare and medicaid, work well enough to make them sufficiently popular that no politician dares to even suggest eliminating them. There are certainly ways in which government interference can go too far. Mandating centralized electronic record-keeping, for example, is an absolutely terrible idea. But opposing *any* government interference in health care because of possible abuses and inefficiencies is IMO throwing the baby out with the bathwater. The debate we ought to be having is not *whether* but *how* government should be participating in our health care system, because the system we have now is b0rken.