June 5 issue, now online
Free for all to read:
- Barbara Mujica’s article about her son’s military service in Iraq, and how it helped him pursue his goal of being “a man for others”: Tours of Duty
- Our editorial on why major health-care reform is so urgent — and why its time may have finally come: We’re Ready
- Just in time for this Sunday’s Tony Awards, a review by yours truly of the favorite for Best Play, God of Carnage, and last year’s winner, August: Osage County: Domestic Disturbances
Subscribers can also enjoy John F. Haught’s article on the theological vision of Teilhard de Chardin; a report by Rev. David Beckmann of Bread for the World on the global food crisis; Charles Camosy’s critique of the CDF instruction Dignitas personae; John Fry’s Last Word on the conversion of the British writer and mountaineer Sir Arnold Lunn; Richard Alleva’s review of the films Earth and Star Trek; the latest edition of Lawrence Cunningham’s Religion Booknotes column; Robert Murray Davis’s review of the new book Graham Greene: A Life in Letters; and David Martin’s review of God Is Back by John Micklethwait and Adrian Wooldridge.
Subscribers to the Washington Monthly should look for our editor Paul Baumann’s review of God Is Back in the May-June issue (not available online, unfortunately). And Commonweal print subscribers will get a generous helping of photos from Iraq along with Barbara Mujica’s cover story. Are you a subscriber? If not, sign up now for just $17!
About health care and the editorial. There’s a very interesting piece by Atul Gawande in the 1 June New Yorker, arguing that the amount of money spent on health care has no necessary correlation with results (high spending can mean poor results, low spending can mean superb results — the Mayo Clinic is an example). He adds that arguments over a single payer system vs. private insurance, or a mix, rather miss the point. High costs come from unecessary tests, which may be defensive (keep away the lawyers) but often simply are made made to increase the income of the doctor or institution ordering them. When medicine becomes too much of a business, he says, the patient may well suffer and the costs skyrocket.
What he does not address (which seems to me part of the equation) is the question of the crushing debt doctors often carry away from medical school, and which must be repaid.
Medicine, as it is too often practised, according to him, needs a cultural as well as financial change. But maybe part of that change is reforming the way medical education is paid for.
Perhaps someone else reading this blog is a doctor (an MD, I mean — I’m sure there are plenty of PhDs) and can comment.
Gawande is at http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?yrail
Mollie, thx for excellent reviews. We saw August: Osage County last summer in NY, and it is an emotional wallop – but still seemed to ring true in important ways. By chance my seat was next to that of a professor of psychology, and during the first intermission, she remarked that her instinct was to rush on stage and start counseling the family :-)
As it happens, we also saw Art last weekend – coincidentally, Steppenwolf has mounted a production in Chicago. I agree with your comments about Reza’s wit, brevity and light touch. Your comment about the translation of God of Carnage reminded me that there were a couple of lines in Art that also seemed kind of forced – I don’t know if the translation was a little maladroit, or if educated French people actually talk that way and the translator just declined to paper it over. But as you say, conversational verity is hardly the point.
Regarding your editorial: yes, I would hope everyone agrees that the “system” we have now is full of holes and the trends are in the wrong direction. Something needs to be done – in fact, should have been done a long time ago.
The question remains, though, whether the Obama solution would be better than the status quo.
If a single-payer option were made available as an option for US citizens, I believe that many, perhaps most, employers would discontinue employer-sponsored health care plans to their employees within five years. The temptation to eliminate a huge cost line item from the income statement would be too tempting. This is particularly true for companies facing competition from overseas firms with a built-in labor cost advantage.
This brief blog post by Yuval Levin raises pointed questions about the fundamental workability of the Obama solution:
http://corner.nationalreview.com/post/?q=ZjRhZjlmNzk5YjNlODg5NWYwMmI3NzliMDIyZjVlZWU=
My family is blessed – I have decent health care coverage through my employer. I’d like the US to find a way to offer something of comparable quality to individuals and families who have no insurance. I don’t believe that dismantling several gigantic industries representing 17% of GDP and gluing together the shards into a federal government-administered program is the answer. I have seen what federal government-administered health care looks like, when I’ve visited VA hospitals in this area. My observation is that it is like government-administered programs in general: The lines are very long, the employees are surly, the rules and regulations are legion, and the budget is woefully inadequate.
I thought your editorial on health care was bold, and I’m disappointed that more folks haven’t engaged in discussing it here. Maybe it’s too “wonky” for general discussion?
I thought the editorial was excellent in terms of saying the system (non-system) we have now is fatally broken (pace JP.) Maybe if government run programs had to deal with all instead of so many uninsured, maybe the process would be better.
A little empathy for those not as fortunate might be a helpful prism to evaluate the large provider issue.
How we move forward is another matter both politically but also strategically.
I thought James Cliftyon’s article in the new America sheds some good light on the latter and I thoroughly concur with Nicholas’s points above as well.
Karen Tumulty’s article in Time looks at five big dilmmas that need to be addressed in order to come up with a workable health care plan.
http://www.time.com/time/printout/0,8816,1902708,00.html
Jim – you make some good points about the health care reform. Much of the discussion is very close to home for me – work for the largest US behavioral health company.
Fact – US business is now behind reform because the cost of providing or subsidizing healthcare for members continues to increase -e.g. would estimate that ExxonMobil spends in excess of $1 billion on medical costs annually. Competition, global economy (yes, competitors that exist in countries with socialized medicine) have the advantage. For whatever reasons, business did not support the ill-fated Clinton effort;
Fact – the editorial only briefly touches on a major factor of costs. The US health industry is set up to treat chronic or catastrophic illness – it rarely supports wellness, health initiatives, etc. We have the medical industry turned upside down – 80% of all costs go to treating 20% of the most ill and we invest so little in the 30-55 age group in terms of supporting healthy practices that keep folks out of chronic conditions, ER rooms, etc. This is a significant paradigm shift and is essential if the US is to transform its medical insurance practices.
Fact – there is much the federal/state governments and business can do to “nudge” folks toward healthy living habits. Can start in the schools and impact the youngest generation. Can be reflected in “sin” taxes on items such as soft drinks, junk food, etc.
It is a complex balancing act.