The magazine did present five options for reform, such as preventing disease, realigning doctors’ incentives, reinventing hospitals, adopting electronic medical records, and covering everyone. They echo the conventional wisdom. But their presentation was so sketchy that it would be hard for any reader to really understand them. Did “Cover Everyone: It’s Cheaper” mean an individual mandate that certainly will be expensive for some of the currently uninsured? Most readers wouldn’t get the recommendation to “pay for holistic success.” I’m not sure what the writer meant. And the suggestion that hospitals are medical “cafeterias” that should not all provide the same services is not likely to fly with hospitals that are fighting viciously with each other to win patients who need the most lucrative services. Plus, trying to steer patients to centers of excellence for various procedures has already been tried by the HMO movement—and consumers resisted. They wanted to go to hospitals close to home, even though the cost may have been higher and the quality lower.
Time’s failure to be more forthright about solutions may reflect the magazine’s internal dissent, or it could mirror the lack of national consensus about how to solve the problems Tumulty so vividly illustrates. There appears to be only a rhetorical consensus—things are bad and something must be done. Which raises the question: Are we headed toward a Fast Food Nation-style conclusion, which posited that food consumers could choose whether or not to eat Chicken McNuggets? When health care consumers get really sick, they usually have no choice. That’s the problem.