Here’s an article in the New York Times which exemplifies so much of what is wrong with our nation’s healthcare system – and the debate on how to fix it.

The article profiles 62-year-old Bob Collier, a sort of everyman from rural Georgia who spoke at Rep. Sandford D. Bishop Jr.’s town hall meeting on healthcare reform. He told the story of his wife, two years younger than he, who was diagnosed with breast cancer. Mr. Collier and his wife had excellent health insurance coverage via his employer, Buccaneer Inc., which paid for his wife’s biopsy and three surgeries. She also had radiation therapy, which insurance refused to cover, labeling it “experimental,” but the hospital waived the $63,000.00 bill for that.

Today his wife is alive and well. Collier spoke of his fear that his wife would be denied life-saving treatment if healthcare reform was enacted and her disease were to return. “She’d be on a waiting list,” he said. He also spoke of his fear that healthcare reform would benefit “lazy and irresponsible people who play the system.”

Now, I don’t want to caricature Mr. Collier and his wife. They both sound like decent, hard-working people. I just wish the reporter had probed him to determine whether he realizes the extent to which his health care is subsidized by others.

For starters, there is the matter of the hefty tax deduction he gets for his employer-based insurance, which is paid for by people who lack such coverage (like, oh, say, me, for example), and who must either purchase their health insurance with after-tax dollars or go without. I’d also like to know how many temps and contractors and free-lancers and consultants and part-timers Buccaneer Inc. employs sans benefits, so it can afford to pay for health insurance for its “benefits-eligible” employees like Mr. Collier.

(As an aside, has anyone besides me noticed the proliferation of that odious term, “benefits-eligible employee?” It has replaced the terms “full-time employee” and “permanent employee” in the lexicon of the human resources munchkins. So you could have been working for the same outfit for fifteen years, you could be working more than a full-time job, but you aren’t eligible for benefits because you’re not “benefits-eligible.” Allrighty, then.)

Then there’s that little matter of the $63,000.00 bill for radiation that was waived. Wonder how many other patients the same hospital has pushed over the edge into bankruptcy since Mrs. Collier was diagnosed with breast cancer?

And of course, in a couple of short years the Colliers will be eligible for our nations’ socialized healthcare system for the elderly, and the taxpayers will be picking up the entire tab.

I also wish the reporter had pursued the question of whether Mrs. Collier is alive and well because of her cancer treatment, or in spite of it. The article didn’t say how her cancer was detected. If it was detected via a routine mammogram, then almost certainly her “cancer” was some tiny, slow-growing neoplasm which never would have bothered her until she died of something completely unrelated.

Still, I don’t begrudge Mr. Collier and his wife any medical intervention which could help them live to a ripe old age. I just don’t see why he is so determined that other people not have the same advantage.

The fact is, we are an insanely overmedicated nation. And I freely admit that extending the same level of overmedication to everyone would break the bank. But that’s not what I have in mind at all.

What I have in mind is a system like that of the UK, in which everyone is covered, and medical interventions are evaluated on the basis of evidence. Those which do not produce robust clinically significant benefits are not indemnified.

Yes, I’m advocating rationing health care. But we already do. Every economic system is, at bottom, a system for rationing goods and services, because our desires are infinite and our ability to satisfy them is not. The question is not Are we going to ration health care, but rather, Are we going to ration health care on the basis of evidence, or on the basis of who has the most money to pay lobbyists to find ways to leverage other people’s tax dollars?

Right now, 58% of health care expenses in this country are paid for by the taxpayers. That's more than total expenditures on health care in all but three other countries. That would be enough to indemnify everybody in this country at the same level they do in the UK, with billions left over.

And that would be plenty good for me. It’s got to be better than our present system, which plies some people (notably the elderly) with all sorts of medical interventions of dubious value, while every year thousands of people die due to lack of medical care and hundreds of thousands are driven into bankruptcy by our Medical-Industrial Complex.

But then again, who cares? They probably weren’t “benefits-eligible” anyway.