Would You Rather? or Reading your way through the Health Care debate

Last night at dinner (at the great new diner in Austin, "24"), me and the fam were playing one of our usual dinner time games, "Would You Rather?"--the game where either choice is rarely a good one.  Besides being a great peek into where your kids heads are at, for us anyway this game is a fun and effective conversation starter--which, as most parents know, is a toughy.

While the son and I typically go for the "would you rather eat 100 raw oysters or 100 snails"-type questions, my husband and daughter always go for the odd/existential/serious questions, like last night's kicker, "Would you rather be a doctor that has to tell someone their Grandfather died, or be a manager that has to fire 100 people on the same day?"

My daughter picked the doctor and when we asked why, she said in her typical "I'm channeling a very cynical 40-year old" voice, "Doctor.  They say it, they fake cry and they walk away..it's easy."  Maybe I should have said the voice she was channeling was a "very, very, VERY cynical person", or maybe she listens more than we give her credit for because outside of my doctor and my brother-in-law, I'm not a big fan of doctors or the system they work for.  We've been in a lot of offices and hospitals in the last five years and I can easily say that I hate them and the system.  At their/it's best they made me hopelessly hopeful.  At worst?  A quivering mass of sobbing doubt.

Anyway, the question and subsequent conversation reminded me that over the past 7 years or so I've had to do a lot of reading about health care for my job.  And, given the current debate/debacle I went through my books and found what I considered to be the best of the best in terms of giving you a fully rounded picture of the issues we face as our elected leadership try to solve the problem that is our health care system.

First, let's get in the right frame of mind...regardless of how you want it fixed, most Americans want something different--especially the 40 million or so uninsured.  So, I'd recommend, "Sick" by Jonathan Cohn.  I found it a compellingly devastating, yet judicious look at decline of our health care system--each patient story highlighting yet another reason that we all need to take this seriously.

Then we should ground ourselves in the history of what is a very unique system of care here in America..."The Health Care Mess:  How We Got Into It and What It Will Take To Get Out" by Julius Richmond and Rashi Fein.    Taking us from the post-WW II start of health insurance to the 'quest for profits' business it is today, they show the sink holes of a decentralized system and lay out their proposed fix.  For what is admittedly a dry subject, they do a good job of cutting through the fat to the key issues below.

Then, a look at hard reality with "Can We Say No?  The Challenge of Rationing Health Care" by Aaron, Schwartz and Cox.  Using the British system--and their choices--as a foil, this book points out the nature of the choices we as Americans face if we want to keep it from being a financial drain to either business or ourselves.  They don't offer their version of a solution, but I didn't mind knowing that this issue truly will take a combined, collaborative effort to solve (which does not give me hope for this round of health care reform either come to think of it).

Then would come the hardest read for me (I tend to shy away from anything written by economists--it's a personal failing I grapple with)--"Healthy, Wealthy and Wise:  Five Steps to A Better Health Care System" by Coogan, Hubbard and Kessler.  Examining the problem a market perspective, they come to identify root causes of the overall mess that I ultimately understood--it was, for lack of a better term, my 'aha!' moment.  From tax code issues that force price distortion to the fact that there is no one measure of quality of either care or care information, they break it down and offer a solution for each.  Whether their solutions are plausible or even smart I can't say, but the issues they identify are definately part of the problem and should be understood and solved for in the long run if we are truly to create positive change for all.

Finally, I'd wrap it all up on a high note with T.J. Reid's fantastic book, "The Healing of America:  The Quest for Better, Cheaper and Fairer Health Care".  Clear, insightful and often humorous, it shows that we can have a system that puts people, not profits, first without losing sight that this is a business. 

And, if you only have time for one book...Reid's is the one to read:  It gives fact-based and hopeful direction for a better system of care and we should all be armed with that because as Congress plays it's own game of  "Would You Rather" with the future of American health care, you want to be ready with a good answer.