Prescriptions for Progress

Published January 1, 2007

The Cure: How Capitalism Can Save American Health Care
By Dr. David Gratzer
New York: Encounter Books, 2006
240 pages, hardcover, ISBN: 1-59403-153-3, $25.95

Clearly the ongoing debate over government’s role in providing health care for citizens is tedious for many, and important questions remain unanswered for most.

In response to that situation, Dr. David Gratzer–a widely cited senior fellow at the Manhattan Institute–draws on his years of experience as a physician in both Canada and the United States to offer several compelling health care reform strategies in his newest book, The Cure: How Capitalism Can Save American Health Care.

Gratzer’s book tackles hot-button issues, presenting the problems and potential solutions in plain language, often with anecdotes drawn from personal experience. In this way, he makes examining the often-confusing pathways of health policy and practice more like a story–deft use of a skill no doubt honed to effectiveness as a long-time practitioner of psychiatry.

Readers unfamiliar with the health care system and the policy debate orbiting it will appreciate his conversational approach to intricate topics, as will seasoned health experts looking for a refreshing viewpoint and new ideas.

Saving Lives

New ideas abound in The Cure–some still in infancy, others already under examination by the public and private sectors.

For example, Gratzer says health savings accounts (HSAs) are the best vehicle for expanding health coverage to the widest possible group of people, while also stimulating the American economy in the most effective way.

He wisely and usefully cites health insurance’s link to employment as the beginning of a third-party payment system that grew to rob individuals of choice, ultimately leading to wasteful bureaucracy.

Gratzer also advocates reform–though not outright elimination–of Medicare and Medicaid. He suggests adjusting age and other eligibility requirements to better account for a more long-lived American public.

Gratzer believes these changes, plus limiting the Food & Drug Administration’s (FDA) pharmaceutical drug mandate to testing and safety evaluations, will save lives, money, and time.

To be sure, not all of Gratzer’s recommendations are new, but they are presented in a new way, refuting some long-held but false beliefs about the poor and uninsured and the role employers and corporations play in health care.

If only to dispel antiquated myths surrounding the issues of Medicare, Medicaid, public versus private coverage, and other areas, this book is an important resource.

Writing Compassionately

Perhaps the most powerful aspect of The Cure is the compassion and concern with which it is written.

Whether Gratzer is discussing the faults of managed care or the factors that make insurance more expensive in some states than others, he humanizes the issues while emphasizing that a serious solution is imperative.

Gratzer concedes health care is dynamic and changing by nature, that no two people share exactly the same needs, and that therefore no one solution will be universally applicable.

Instead of scoffing at the idea of private insurance, he suggests that with current tax laws and FDA regulations, private insurers have become far less effective over time. He says other avenues of insurance access would be better–HSAs and high deductible plans with low premiums, for example.

Gratzer does not reject government-run universal coverage out of hand, but he details his own experiences with it, explains how it has failed in Canada, and tells why it will not solve America’s health care problems.

Understanding Economics

Instead, Gratzer says, economics will save American health care.

He points out the health care system is the only facet of the U.S. national economy not driven by Adam Smith’s “invisible hand”–true interplay between supply and demand–and that the system that has developed in place of organic, neoliberal economic policy has, in effect, created barriers to trade. This has caused decreased access to care at higher prices than the market should bear given all of the advances in modern medicine.

So what is Gratzer’s well-conceived cure? Let America do what America does best: Create a self-regulating market for health goods and services, free of excessive and inefficient government meddling.

Targeting poorly administered programs at the federal and state level for elimination, and allowing value and personal choice to regulate the health care market in an organic way, is an approach individuals and employers alike can appreciate. This, in turn, will make the problem of reforming surviving entitlement programs easier to manage.

Where there is true competition driven by value-conscious consumers, the market will flourish, value and access will increase, and individual satisfaction with health goods and services will increase.

Economically and socially sound, Gratzer’s prescription provides lots of cure.

David Salvo ([email protected]) is a freelance writer living in Indiana.