Look, something has to be done about health care costs in the U.S. We've probably got the best medical care in the world -- when we can pay for it.
I don't know if the health care reform bills will prove to offer decent solutions. But it seems to me it's obvious what some of the problems are.
There are huge disconnects in our health care system.
Free markets work when consumers have a choice of providers and can shop for price and quality. If I can't afford a BMW, I might go for a Honda. It's up to the sellers to give us the best product or service they can for the lowest price they can.
Those are foreign concepts to the health care industry.
Here's the first disconnect: We're not talking about a new car or a new home or a better job. We're talking life or death. Our own life or death.
Everybody wants the best health care possible. When it's your own life at stake, you don't want to say, "Well, what's the best doctor I can get for my budget? Maybe I can stop getting those lattes at Starbucks every day and pay a little more."
You want the best. Period. Whatever it takes. And you're really pissed when you can't get it.
Of course, most of us can't get the best.
Eleven years ago, my sister got breast cancer. When she first found she had breast cancer, I brought her up from Santa Barbara to San Francisco to talk to a specialist at UCSF. I had absurd notions of paying for her care myself, or paying the difference between what was covered by her insurance (which was very good) and what the best treatment centers would charge.
Yeah, right. There's no way anyone with a salary of less than $50 million a year can afford the best.
Several years ago, I also read Lance Armstrong's autobiography. He had cancer that almost nobody recovers from. Then he found that he had lost his health coverage. But, let's face it, he had already made millions of dollars and was famous. Doctors were willing to treat him just because he was famous.
They got mentioned in his autobiography.
Lance went broke getting treatment-for a while-and had to fight to get his coverage back. But he got the best treatment in the world.
My sister died.
Five years ago, the cancer we thought was gone metasticized and spread to her brain. The fourth anniversary of her death is June 29, the day after her 57th birthday.
Life just isn't fair. We just have to deal with it. Even in health care.
What's surprising to me is that most wealthy people don't get it.
More than a decade ago, I did an interview with Oracle CEO Larry Ellison. He was talking to me about why he was trying to get some initiatives together to improve public education in the U.S. He said that President Clinton talked about the health care crisis, but if that was a crisis, education was a disaster of epic proportions.
Personally, I don't know which is worse in this country, the problem with health care or the problem with public education.
But Ellison's justification was this: If health care in this country was so bad, and Canada's socialized medical system was so good, then why did so many Canadians with life-threatening illnesses come to the U.S. for their treatment?
Yeah, well, maybe the folks who go to the same parties he does. But not the average Canadian. The ones coming to the U.S. for treatment are the ones who can afford the extraordinary treatment we're famous for.
But the problem in the U.S. isn't just that the average person can't afford the best health care. It's that the average person can't afford average health care.
We may or may not have the best medical treatment in the world. But we certainly have the most expensive.
Here's some data from a Senate Finance Committee report from April 2009:
In 2008, the U.S. spent more than 17 percent of its gross domestic product on health care. That's more than any other industrialized country in the world, both in total cost and in cost per capita.
By 2017, the report estimates it will reach 20 percent of GDP. That's $4.3 trillion annually.
According to my calculations, at this rate, health care costs should reach 100 percent of GDP by about 2105.
I knew I should have gone to medical school.