Lunch or Lipitor?

Americans will likely consume fewer prescription drugs this year than they did in 2007, the first yearly decline in more than a decade, according to the lead story in today's New York Times. 

Several factors are likely behind the highly unusual decline, including a reaction to recent safety issues with some prescription drugs that may be making Americans more reluctant to treat every malady or discomfort with chemicals when other remedies are available. But the primary reason, according to the authors of the study on which the article is based and the Times' interviews with citizens, is that the deepening recession is increasingly forcing Americans of modest means "to choose between gas, meals and medication," as one doctor put it. 

Before I comment further on this development, I think it's important to contrast this lamentable reality with the notion, advanced by an anonymous commenter on this blog two days ago, that "America since 1980 has been a much better place for every American compared to the years before." Leaving aside the absurd presumptuousness of this assertion (how could any of us deign to know just how well or badly "every American" has fared in the past quarter-century?!), the recent deterioration of health care coverage surely refutes such a rose-colored, blanket statement.  

But far more importantly, the situation outlined in today's headlines also underscores that our health care system is simply not delivering the proper treatment to everyone who needs it. 

I don't have a solution to this problem (if any readers have ideas, I would love to hear them). But both candidates for president purport to have one. Trouble is, as another Times story points out today, both of them are irresponsibly misleading citizens about their plans — especially regarding how many uninsured they'd cover and how much it would cost to do so. 

True, these are details that may be impossible to pin down before the election ends and the process of piloting health-care reform legislation through Congress begins. As the Times piece correctly points out, this is because of the black-and-white nature of modern campaigning as well as the inability of economists to predict accurately how human beings will respond to dramatically changed rules and incentives. 

But someone will win the election, and subsequently try to implement his plan. At that point we need to demand clarity about just what we're getting into. The risks are great. On one hand we risk failing to do enough to address a growing problem that has a multiplier effect on our economy. People with inadequate health care get sicker, further straining the system and raising costs for everyone. Sick employees don't show up for work, reducing efficiency and raising costs for employers. And soaring insurance costs hurt American companies' ability to provide jobs and compete with global rivals. On the other hand we risk doing too much and saddling the system with inefficient, government bureaucracy, potentially leading to the long wait periods and de-facto rationing of care we see in single-payer systems like Canada's. 

Like many of the challenges we face, health care is a complex problem that is not given to the tidy, partisan sound-bite solutions that have become the coin of today's political realm. That's why we all need to be involved. Your representatives in Congress will vote on any plan that either McCain or Obama tries to pass. Pay attention to the details when that time comes and make your voice heard.