I’m back from a trip to the American Academy of Dermatology’s annual meeting where Dr. James Leyden was given one of the Academy’s highest awards, the Livingood Lectureship. Leyden’s talk was about health care reform and how insurance was the problem, not the solution. Mirroring a lot of the things I’ve been thinking, Leyden pointed out the problems of having health care paid by a third party. The lack of accountability warps the market and leads to uncontrollable cost.
Leyden had many specific analogies. One of my favorites was that we now have a health insurance system that would be like having auto insurance that paid for oil changes and gasoline. It isn’t efficient, and it doesn’t make sense.
Instead of demonizing insurers or drug companies, attorneys or anyone else, let’s focus on the real problem, accountability for cost. Who will be accountable? Do we want the insurers to tell us what drugs we can or can’t have? Do we want the government to do it? If not, we need to take responsibility ourselves.
For more details on my thoughts, see my article in the last issue of the North Carolina Medical Journal (http://www.ncmedicaljournal.com/Jan-Feb-10/ReadersForum.pdf).