the underlying cost of care problem

At least 7 users of TPMCafe heartily recommend Atul Gawande's recent New Yorker article, "The Cost Conundrum" on this topic. If you're interested and haven't read it, you absolutely should, it's at least a start at comprehending the enormity of the changes we need.

I find the debate about what to do about health care remarkably superficial and unenlightening

Me too, a lot of it is the same old, same old.

I understand why people do it, for the agitprop, to make sure everyone is convinced. But I've gone way beyond that, I learned those things at least fifteen years ago. And judging from recent polls, most other people have too. Yeah, the health insurance situation is a nightmare, we all know it, I don't need to keep reading it over and over and over. If we haven't experienced it ourselves, we surely have friends and relatives who have, and we have all heard the horror stories already since the Clinton years.

For example, people talk as if "Medicare for all" would solve the problem and then everyone will be happy. Now someone like me, I'd be happy because I have no coverage right now and something is better than nothing. But excuse me, hello fairy tale believers: current Medicare is in crisis and its projected costs for the boomer generation are a big problem! Not to mention if you have any experience with it, like with elderly parents, you realize Medicare is not the only coverage many over 65 have, and if many that have problems did depend on it, they would be in real shit trouble. You know how good retirees' medical benefits caused such problems for the auto companies, because they were so expensive? That was for over and above what Medicare covers, duh! I read the argument often that nobody complains about Medicare. Well, nobody complains because most people have extra coverage from former employers or the Veteran's Administration or the like, and if they don't they are too poor to be blogging about it or too poor to be talking to pollsters, OR they are dead from improperly treated chronic illness because Medicare Part B didn't cover the preventive measures necessary, like check ups.

already much higher than they are in the rest of the world

I think even this oft-repeated point, though true, skews the discussion towards pie-in-the-sky land. We are way behind in reform, but that doesn't solve the problem. BECAUSE most other countries are experiencing the skyrocketing costs of all the new medicine available TOO, costs are eating up a greater amount of their GDP each year, too, and they TOO are in a quandary about what to do about it. So the reality is that reform of our system to be like other country's systems would still leave us with skyrocketing costs. To promise that single payer or whatever would fix all of this is to insure disappointment and failure. We have to do BETTER than those other countries, even though we are starting from behind. They don't have the whole answer.

I'll give you one example. We currently "stealing" a lot of doctors from places like India right now because we have the higher renumeration for doctors and the need for them. If we are no longer so attractive to doctors in renumeration, where are we going to get the doctors? We really do need to reform the way we doctors and the way they get trained, I have heard Obama push this and he is right to do so. We don't even have enough primary care doctors to take care of a retired boomer generation, and expecting the few we have to take less pay is unrealistic, many will just opt out and serve those who are willing and able to pay out of pocket.

I am starting to think that perhaps the boomer generation (of which I am part) will just have to deal with not getting ideal service during a transitional period, sort of serving as the guinea pigs, so that the next generations have a decent system that works. It's not going to be fun, The least of which: I predict lots of health care complaint threads, on that old-fashioned medium, blogs, by retired people, heh.