Rob McCray’s response to “Top Down Versus Bottoms Up Health Reform”

May 29, 2014 | Reply More

In the Forbes Op Ed piece “Top Down Versus Bottoms Up Health Reform,” Chris Conover denounces Obamacare’s “top down” approach to health care reform. He argues instead that market-oriented health reform is necessary to fix the American health care system. Conover’s criticisms focus primarily on Obamacare’s mandate that birth control be made available on every plan and the requirement that each health plan falls within a titled tier of care. He argues that it isn’t “government’s business to make such decisions” about the availability of birth control and that the designated health tiers interfere with consumer freedom of choice. Likening health plans to the array of cereal brands one finds at the grocery store, Conover asserts ”The very same Americans who somehow manage to figure out which of 150 different cereals to buy (each representing a rather dizzying array of ingredients, nutritional value and price) evidently are too blazingly stupid to put those same shopping skills to work when it comes to choosing a health plan.”

Read Rob McCray’s response to Chris Conover’s piece and tell us what you think about “Top Down” and “Bottom Up” reform:

“Chris,
Certainly ACA is a flawed effort, but objectivity demands acknowledgement that it is intended to modify (not restructure) a structurally flawed American healthcare system and was created within a diabolically flawed political environment.

On the merits, how can you compare a choice about what cereal to purchase for $3.99 with the choices that a 78 year old woman with possible heart disease or diabetes has to make? which physician, hospital, medication regimen and monitoring platform should she select? Perhaps she does not need any of this? A simple change in diet may resolve her complaints. The price of these choices may range from hundreds to tens of thousands of dollars. Of course health care needs trusted organizers, curators and negotiators. People cannot do this for themselves. Examine the power and auto sectors. These are large essential industries that have become better and cheaper over time through a combination of private investment and competition, government investment and regulation, and public transparency as to costs and outcomes. We need to find the same mix of these ingredients if health care is to be fixed so that, as with automobiles and power, health becomes “better and cheaper” over time. Oddly, we had another flawed effort to reform American healthcare in the 1980′s and 90′s, called “managed care.” It was private industry driven with Medicare encouragement but unfortunately was done in by a combination of overreach and resistance from physicians and patients. Hopefully we can do better this time around.

FYI, the title to your essay caught my eye as it is similar to on I penned earlier this year, covering some of this ground –

http://wirelesslifesciences.org/2014/02/top-down-technology-needs-bottoms-up-demand/.

Rob McCray”

Read the full Op Ed here: http://www.forbes.com/sites/theapothecary/2014/05/28/top-down-versus-bottoms-up-health-reform/ 

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