As Atrios says, an interesting thing about this ad by Ron Wyden is that it dares to suggest that many of us may be trapped in jobs we hate because of the need for health insurance or just plain old access to affordable health care. It's generally taboo to admit that life for most of us is less rewarding, financially or otherwise, than it was for our parents.
Which is as good a segue as any into this passage taken from a new article by Robert Kuttner in the New England Journal of Medicine:
Changing demographics and medical technology pose a cost challenge for every nation's system, but ours is the outlier. The extreme failure of the United States to contain medical costs results primarily from our unique, pervasive commercialization. The dominance of for-profit insurance and pharmaceutical companies, a new wave of investor-owned specialty hospitals, and profit-maximizing behavior even by nonprofit players raise costs and distort resource allocation. Profits, billing, marketing, and the gratuitous costs of private bureaucracies siphon off $400 billion to $500 billion of the $2.1 trillion spent, but the more serious and less appreciated syndrome is the set of perverse incentives produced by commercial dominance of the system.
Markets are said to optimize efficiencies. But despite widespread belief that competition is the key to cost containment, medicine — with its third-party payers and its partly social mission — does not lend itself to market discipline.
The Invisible Hand is slapping us around. (It's also attached to some parties who would rather we didn't know they existed, so we would be forced to blame our plight on 'market forces' as opposed to actual perpetrators.)
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