🏦 "It's the financing system, stupid"
Adam Gaffney on moving past prices as a way to understand U.S. healthcare
First there was the over-utilization hypothesis.
Then there was the high prices hypothesis.
Now, meet a new hypothesis: it’s the financing system, stupid.
That is what Adam Gaffney concludes in a 5,000 word article published last month in the Boston Review. Gaffney, a physician and instructor at Harvard Medical School, argues that recent academic literature and investigative reporting on the high price of care are still missing a fundamental
problem with the way we understand healthcare in America.
It’s a piece worth reading in full, but if there is one sentence that policy makers should absorb from Gaffney’s it, it’s this:
High prices are not incidental to our reliance on private insurance: they flow, in no small part, from it.
💔 Understanding a broken system
In order to understand why that sentence is so important, Gaffney takes the reader on a brief tour of recent scholarship about America’s broken healthcare system, beginning with the idea, popularized by renowned surgeon Atul Gawande, that the problem with healthcare is that we use too much of it.