Newt Gingrich (not usually my favorite guy) had a piece in the WSJ last week that caught my attention. I like outside the box thinking, arguments that challenge pre-conceived notions of reality and Gingrich raises a good point--- namely, why do we automatically assume that spending 17% of our GDP is too much? The standard interpretation is that this repesents an ungodly waste of resources and money. No other country spends so much on health care. What can we do to reduce such exorbitance, the thinking goes.
But there's another way to look at it. Maybe in America, we don't have so much a health care system as a health care industry. And this industry is an economic lifeforce for many Midwestern cities in this post-industrial, post-manufacturing era of American hegemony. In Cleveland, Ohio, if it weren't for the Cleveland Clinic and University Hospitals, unemployment would be over 20% easily. Blue collar America doesn't have the steel mills and the automotive factories to send its men and women off to every morning. Those jobs are gone, never to return. And the healthcare industry has stepped in to bridge the gap. Whether this is a sustainable long term economic model is difficult to say. But for now, all those expensive pharmaceutical drugs and outpatient radiology centers and the titanium hip components and fancy new hospital atrium construction also provide jobs and a means of existence for Joe the ex-plumber.
We need to ask ourselves whether this is all a mirage. Is it reasonable to assume that the jobs created and capital raised from the health care/innovation sector can replace the factory-based way of life that has been the foundation of blue collar America for half a century? And if it isn't, then what the hell is the alternative? People need to work. Green jobs? High tech digital? Biomed? Transitioning from an industrial economy to whatever else is next is America's next great challenge. But before we demonize the healthcare sector as just an expensive, bloated monstrosity, perhaps we ought to make sure there's a safety net to catch those end up losing jobs when we start shutting down surgicenters and outpatient radiology clinics and making it more difficult for the pharm industry to get new drugs approved....
Cal Coolidge once said, "the business of America is business". But what happens when that business is also burdened with heavy moral baggage (fair and equitable distribution of health care to all) which can compromise the pure profit driven motives of most industries?