Some people will undoubtedly read a new Atlantic article titled “How American Health Care Killed My Father” and conclude: “This is precisely why we need the government to step in and improve our health-care system.”

That would be a shame, since the article’s author, David Goldhill, concludes his piece by warning against any changes that shift health-care decisions even further away from the patients and family members those decisions affect.

Before reading the following passage, you need to know that Goldhill’s father died from a hospital-borne infection, the type of problem avoided when hospitals institute practices such as requiring doctors to wash their hands more often.

Ten days after my father?s death, the hospital sent my mother a copy
of the bill for his five-week stay: $636,687.75. He was charged $11,590
per night for his ICU room; $7,407 per night for a semiprivate room
before he was moved to the ICU; $145,432 for drugs; $41,696 for
respiratory services. Even the most casual effort to compare these
prices to marginal costs or to the costs of off-the-shelf components
demonstrates the absurdity of these numbers, but why should my mother
care? Her share of the bill was only $992; the balance, undoubtedly at
some huge discount, was paid by Medicare.

Wasn?t this an extraordinary benefit, a windfall return on American
citizenship? Or at least some small relief for a distraught widow?

Not really. You can feel grateful for the protection currently
offered by Medicare (or by private insurance) only if you don?t realize
how much you truly spend to fund this system over your lifetime, and if
you believe you?re getting good care in return.

Would our health-care system be so outrageously expensive if each
American family directly spent even half of that $1.77 million that it
will contribute to health insurance and Medicare over a lifetime,
instead of entrusting care to massive government and private
intermediaries? Like its predecessors, the Obama administration treats
additional government funding as a solution to unaffordable health
care, rather than its cause. The current reform will likely expand our
government?s already massive role in health-care decision-making?all
just to continue the illusion that someone else is paying for our care.

But let?s forget about money for a moment. Aren?t we also likely to
get worse care in any system where providers are more accountable to
insurance companies and government agencies than to us?

Before we further remove ourselves as direct consumers of health
care?with all of our beneficial influence on quality, service, and
price?let me ask you to consider one more question. Imagine my father?s
hospital had to present the bill for his ?care? not to a government
bureaucracy, but to my grieving mother. Do you really believe that the
hospital?forced to face the victim of its poor-quality service, forced
to collect the bill from the real customer?wouldn?t have figured out
how to make its doctors wash their hands?

HT: Joe Coletti