On my way to Singapore this summer I reviewed a pre-publication copy of Dr. Richard N. Fogoros’s book, Fixing American Healthcare; Wonkonians, Gekkonians and the Grand Unification Theory of Healthcare. There’s a blurb from me on the opening pages of the finished product:
Dr. Fogoros has hit the nail on the head with a bold, insightful critique of the U.S. health care system and a plan for radical reform that just might work. Fixing American Healthcare is a much-needed antidote to the fruitless incrementalism that dominates contemporary debate.
I meant what I wrote. Unlike others who dance around the topic or try to have it both ways, Fogoros doesn’t shy away from embracing bold, unpopular ideas as cornerstones of his solution. Here’s a taste from early on in the book:
[R]ationing of healthcare is a central theme in this book… I am not talking about something bland or benign… There is nothing pretty about rationing healthcare. Rationing is bad, and if we’re going to do it we should at least be willing to acknowledge exactly what we are doing. So here’s the definition I like: To ration healthcare is to withhold medical services from individuals who would probably benefit from them because we have decided not to buy those services for everybody who needs them.
I like this definition because it’s straightforward. Also, it puts the onus on us… instead of those nasty “scarce resources” themselves. That makes it harder for us to dance around the real issue, which is: if we’re going to ration healthcare then we ought to do it in the least harmful way possible.
Fogoros makes a compelling case that the problem with our current health care system is covert rationing, which has profound corrosive effects. Once the problem is laid out, Fogoros proposes a solution that encompasses open rationing and is characterized by six key principles. Among other things he wants to see competition between health care and other services provided by society, and rationing decisions left to individual patients to the extent possible.
Fogoros also insists on universal health care coverage as a key principle. Presidential candidates who advocate the same thing should study Fogoros’s book to see how it might actually be done.September 24, 2007