Loser-free health-care reform
To say another word about the fuss over the Dartmouth Atlas project, it's worth talking for a minute about why people so badly want the project's conclusions to be right.
The Dartmouth Atlas project has amassed an enormous amount of data suggesting that up to 30 percent of our health-care spending goes to items that don't do anyone any good. It's wasted money. If this is true, it's absolutely great. Or it at least has the possibility to be great. It means we don't have to ration.
We know that we're going to have to eventually cut health-care spending by quite a lot compared with what it would be if we don't do anything. There are probably three ways to do that: Make care less affordable (high co-pays, for instance), less accessible (waiting lines) or less profitable (government bargaining). All of those approaches will have losers. Lots of them, in fact.
But if the Dartmouth Atlas project is right, and if its findings can somehow be put into policy, it offers a loser-free way out of our predicament: You take away care that no one needs. That means no one loses. In fact, some people win, as unnecessary care carries risks of its own. That's much easier for politicians to sell, and it looks like it's actually true. The only question is whether we can figure out how to separate the good care from the bad. And we won't know that for years to come.