Blog Roll: Healthcare

 

“...the executive of the modern state is but a committee for managing the common affairs of the whole bourgeoisie” Marx’s famous formulation in The Communist Manifesto.

Understanding Society+1

The PBS video (above) plays an interview with a Primary Care Physician explaining (1) why US Healthcare is so expensive and (2) why nothing is going to be done about it ("...the system is designed to make money off illness..." and it makes a lot of money).

Here is my Directed Graph summary of a chatGPT dialog on Healthcare Reform:

and

Posts

• Policy Wedges and State-Space Simulation Models If ever there was any political will, there is a way to control the US Healthcare System.
• US Healthcare Expenditures: Three Futures There is no political will for keeping Health expenditures in lie with growth in the US or the World Economy.

Notes

Questions

1. What is the Medicare Sustainable Growth Rate? Why didn't it work (the "Doc Fix")?
2. What does the history of attempts to control US Healthcare say about the possibility of Medical Cybernetics?

Readings

Pasdirtz (2007) Controlling the US Healthcare System with Policy Wedges Springer Health.

Google AI Summary

George W. Pasdirtz’s 2007 paper “Controlling the U.S. Health Care System with Policy Wedges” introduced a state-space modeling approach to address the long-term growth of the U.S. health care sector, which has historically expanded faster than the economy PubMed+1.

Core Methodology

Pasdirtz built two state-space models:

• U.S. economy model (1950–1999)

• U.S. health care system model (1950–1999)

The economy model’s output served as a reference input to control the health care model’s growth, allowing simulation of a “controlled” scenario where health care growth matched economic growth PubMed+1.

The “Policy Wedges” Concept

A policy wedge is a targeted intervention that shifts the growth path of the health care system toward the economy’s growth rate. These wedges are measurable, policy levers—changes in investment, pricing, or service delivery—that can slow health care growth without eliminating care macropolicyspace.blogspot.com+1.

Key Findings from Simulations

To align health care growth with the economy over the late 20th century, Pasdirtz’s model suggested:

• 13% reduction in capital expenditure

• 15% reduction in drug prices

• 32% reduction in physician service prices PubMed+1

These reductions would have brought health care spending as a share of GDP from 3.4% in 1950 to nearly 14% in 1999 back in line with economic growth PubMed.

Application to Universal Health Care

Pasdirtz also applied the framework to universal health care design:

• Use planning and economic incentives rather than over-engineering benefits

• Avoid centralized, command-and-control approaches

• Balance coverage and cost control through targeted interventions macropolicyspace.blogspot.com+1
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Significance

The “policy wedges” approach offers a quantitative, simulation-based roadmap for:

• Cost containment in health care

• Universal coverage design

• Data-driven policy-making that avoids ad hoc or politically charged reforms macropolicyspace.blogspot.com+1

In short, Pasdirtz’s framework provides a macroeconomic modeling tool to test counterfactual outcomes and design policies that align health care growth with economic growth, with practical implications for both cost control and universal coverage.