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Back in college, I had my first health scare.  A bit of road sand hit my eye while I was biking, causing a painful and urgent wound.  I made my way to the clinic and stewed in triage for the appropriately excruciating amount of time waiting for others to get their gunshots and plagues attended.  After seeing a doctor with some saline rinse and some UV contrast, I was sent hime with an eyepatch and told to get rest.  Which was miraculous.  Apparently the cornea heals fast.  I had no need to panic at all

What did cause some panic was the bill.  Along with sundry reasonable items like he doctors time and a $2.50 shot glass of saline, I was dismayed to see that the box of tissues was $16.00.  The hospital needed to make its money somehow.

Aside from the dangers of delinking consumers from customers, reducing price sensitivity to services, constraining the mix of doctors by a professional organization, pricing practitioners who make their everyday livings on services their consumers use very rarely, under duress, and in their worst health, the primary problem with health care is that it is inelegant.

Our health care system is spectacularly advanced.  Hospitals routinely have multimillion dollar machines that one in ten thousand of us ever need.  In a big city, that means they get used several times a day.  They still need to be paid for.  The machines themselves are not the total of expense.  A hospital is the locus of the most advanced and sanitary utilities you will ever find, from pipes to procedures.  The whole thing is designed to be safe and sanitary.  All the diseases come there to play after all.  So it needs to be sanitary.  This does not come cheaply for anyone.

How much better could it be if we could get healthy when we needed, and stay healthy when we already were.  It sounds like a pie in the sky notion, but it is simply the converse f our current “wealth care” system.  Getting sick is a double misfortune that we ensure against, on pain of poverty.  The system is overbuilt for our everyday needs.

This is glibly similar to the American transportation system.  We spend a lot for exquisitely fast, long distance service, and wonder why transportation is now the second largest expense in our households, behind housing itself.  Health care is something like 6th or 7th in this list.

We could have a transportation system that was more affordable, if we were willing to let go of the notion of maximum speed for all who could afford it.  Similar to the way we could have health care that was adequate for keeping most people mostly healthy most of the time.  As it is, we are required to spend a trillion dollars every year on transportation, and tens of billion on wealth care, for the inelegant pursuit of goods that we don’t get to enjoy most of the time.

*Writing this on the Bus.  Apologies for the syntactical errors.