Thoughts about health care after the president's speech

When I started this post I thought about listing the problems with the current system. They should include:

#1 - Consumers have no idea about costs
#2 - Tort cost in the system is high - 4% but the losses are not the only things - the threat of litigation has two collateral effects - increased cost of malpractice insurance and over reliance on tests over judgment to reduce the possibility of litigation.
#3 - Some insurance companies have acted inappropriately toward people who use their products. According to most independent analysis, the actual number of people who get cut from insurance from pre-existing conditions is small. But there is enough evidence that the system could be improved.
#4 - The cost of our public option components is increasing exponentially. Medicare and Medicaid will grow by 3X GDP for as far as we can project - why would anyone think about extending a model like this to even more people?
#5 - The process for the recognition of new drugs needs work. According to one estimate about 80% of the cost of developing new drugs is caused by our FDA process. We need to think creatively about ways to assure protection without driving costs through the roof.
#6 - Scarce resources are utilized inefficiently - as noted in an earlier post my experience with a friend in an ER gave me a new look at people who use this very expensive delivery system as their primary care option.

In my mind there are also a number of things where common understanding is mostly wrong. For example, the oft cited statistic about our system versus others in the world (Among the developed nations we have the worst life expectancy) is bunk when you control for things that are not present in those other systems (Americans live in a country where more people die from firearms, we drive more and our immigrants do not effectively use the system.) The public option places all have complaints about lines in the system. John Stossel did an excellent report about the Canadian system.

But then came the President's speech, which I thought was both rhetorically well done and full of a couple of holes (I find it bizarre that he could claim it is possible to simultaneously say no current benefits will be cut, everyone will be covered and there will be no increase in costs. One cannot square that circle.)

From my perspective, the final issue is whether we can even speak in the same language about the issue. There is so much chatter around that it is hard to discover the real set of issues we should be talking about. Without clarity about the sense of the problem it will be impossible to get to a solution.