I mostly agree with Krugman's piece, but I believe there are many reasons for the high and rapidly rising costs, not least of which is the entitlement view of health care. This requires a major change of attitude by all of us as health care consumers, reform of mal-practice, efficiencies by insurers and providers, etc. Easier said than done.
A step would be decoupling employer health provided insurance, but the other essential move is for consumers to pay more out-of-pocket for the services we use. This could be accomplished (not easily) by giving employees more of their health care benefits directly in their paychecks and simultaneously raising the co-pays that HMOs and insurance companies now require, while still offering catastrophic protection. This could be done as a step toward increased use of health care savings accounts, which I favor.
I agree with Greenspan that we are on a terrible collision course in Medicare and Social Security with 77 million Baby Boomer retirements looming. Perhaps, if we are to find a solution for that train wreck, at the same time we can muster the political and personal will for a massive reform that will stabilize the costs for health care.
Unfortunately, the political will for real reform is not present in either party. The prevailing rhetoric that we can grow the U.S. economy fast enough to find a way to pay for all this at current benefit levels is a pipe dream, IMHO.
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