A bit of liveblogging...

I'm currently sitting in on a debate on the prospects of our health care system, and since I have a nice, small, and mobile laptop as well as a good wireless signal, I thought I would post a few comments while the debate was going on... the participants are Craig Savage from Health Planning Source and Michael Cannon from the Cato Institute.

- As one might anticipate, the guy from Cato (Cannon) advocates for getting the government out of the way and let the market magically take over. A nice side point for the guy is that he supports drug re-importation... (It should be a free market). It is nice to see not only because I feel the same way on this point but also because he is being consistant in his ideology despite Dubya's stand on this issue. Say what you will about the Cato Institute, they are generally very consistant in their ideology and are willing to criticize both sides if need be, and I respect that.

In Q&A, I asked about how his market-based solution would work in rural areas and other areas where access to health care providers is limited. I wasn't very happy with the economic portion of his answer (it was rather pithy) but I was pleasantly surprised with his push to open up the regulations to allow more members of the allied health professions to perform particular procedures etc. While this can certainly go bad at certain point, there are a lot of things that can be done by non-physician health care providers (and Cannon agreed with it heartily).

- Savage hit a few points that I think are very important and don't get much mention: Bad actors, the value of preventative care, regional variability, and overuse of the medical system by the over-insured. Preventative care is one of my big favorites in particular, but unfortunately these topics aren't politically sexy and tend to get put to the side.

I was also surprised by a few points he dwelled on: he gave kudos for clinical research by this administration and was very adament about the practice of "Fear Medicine" by physicians. On the first point, I can only imagine that he was thankful that Dubya didn't dip into the NIH's budget to help pay for the war or his gigantic tax cuts because the Clinton-era doubling of the budget is coming to an end and a lot of researchers are going into leaner times. Regarding the second, this is a common line from those hammering on the issue of tort reform... I am not certain what he thinks on that issue; certainly you can have an increase in "Fear Medicine" if the *perception* of malpractice suits worsens. Also, malpractice insurance would certainly skyrocket if you did get sued, but that might be a function of the insurance industry itself.

In Q&A, I asked Savage to further qualify his views on tort reform and got a bit of a different picture from him... it appears that, like me, he is worried about the fundamental issue of rising malpractice insurance premiums rather than tort reform for its own sake. Unlike me, he thinks that is one area of many that needs reform (I think tort reform is a major red herring), but he also endorses other solutions. One of the more important of these is how poorly the medical community polices themselves: a very small percentage of doctors are the source of a very large percentage of verdicts and settlements, but they are still practicing! I entirely agree that reform is needed in this area.

- On the point of universal care, Savage reframed the question to say that the government should ensure access to coverage and care for all citizens (not insurance all citizens). He hit the concept of health care savings pretty hard with the standard arguments... and he also mentioned something I never realized: health care savings that have not been used can be rolled over into an IRA. That certainly stinks... the big thing is that folks would be de-incentivized to access health care services, particularly for preventative care services. Nice.

Of course, Cannon spoke against the notion of universal health care as well, but rather than talking much about alternatives and how to increase access, he pretty much spent his whole time on the negative aspects of universal health care... that can be instructive, but at the same time you need to take the opportunity to present your positive vision. He was also not very convincing on the issue of Health Savings Accounts during the Q&A session... all Savage had to ask is "Where does the HSA money come from if I am near-poor?" (which Savage is) and Cannon was reduced to stutters and double-talk. And nothing on how this will help the poor (and chronically uninsured). Not very pretty to watch.

So what is the verdict here? This was a very good debate, and that is saying a lot considering that one of the co-sponsors was the Committee for a Better Carolina (which described themselves as nonpartisan... riiiiiight). I learned a few things, and got the chance to temper my beliefs in the fires of open debate. Good stuff.

Another verdict: liveblogging is hard! I had to type a few thoughts after the fact, which kinda negates the points. Not being able to touch type hurts a bit as well...