American Consequences - September 2018

THE U.S. HEALTH CARE SYSTEM

Both the perfect collective goods of a low-cost, minimum- bureaucracy health system coupled with highest-quality, maximum-choice individual health care cannot coexist. It is self- delusion to think that it can be so.

the access to and equity of the system is, of course, the Holy Grail. That noble quest will take some time. What are the solutions in the meantime? Hell if I know... Pick your parents well. Make a lot of money. Save more than you need. Don’t get unlucky. Import your own pills from Canada or India (a legally gray area). Get dental work in Mexico or Thailand. Have surgery in Argentina, Costa Rica, or at home (the “suture self ” plan). Run, bike, lift weights, and eat oatmeal with blueberries. And if all else fails, choose to go with dignity and not saddle your kids and grandkids with the bill. A good life not prolonged at all costs and a “good death” should be the goal for the individual... And fiscal responsibility tempered with compassion should be the goal for the state and the health care system. Health care need not be the death of us all! Kerry D. Moynihan has had a long career in executive search consulting, specializing in working with leveraged buyout and venture capital funds, public companies undergoing dramatic growth or rapid change, and restructuring boards of directors. He also does executive coaching and connecting management teams with capital partners. Kerry is a graduate of the University of Virginia in English literature and holds an MBA in finance from the Wharton School. He has worked with clients on six continents and holds dual U.S. and EU citizenship.

moral conundrum that the medical profession and the general populace must face head on. And so you know that I am willing to eat my own cooking, I have specific advance medical directives in place for myself and my 94-year- old mother. Despite the frequent lamentations that typically begin with the phrase, “Why can’t the richest country in the world do...,” Americans must finally recognize that merely containing the incessant rate of cost increases is not enough. A value shift denying some citizens access to the finest care that modern science has to offer is not the answer, either. It is very difficult, if not impossible, to be both the lowest-cost producer as well as the highest-quality supplier. Both the perfect collective goods of a low-cost, minimum- bureaucracy health system coupled with highest-quality, maximum-choice individual health care cannot coexist. It is self-delusion to think that it can be so. A plan that will improve the quality of care, lower costs, cut bureaucracy, and improve

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