Malcolm Gladwell, writer of The Tipping Point and Blink, wrote an article on “the bad idea behind our failed health-care system”, titled The Moral-Hazard Myth in the latest New Yorker.

Mr. Gladwell talks of how (incredibly) inefficient our health system is, especially when compared to other countries - we “spend $5,267 per capita on health care every year, almost two and half times the industrialized world’s median of $2,193″, and the extra money buys us less doctors, less equipment and less satisfaction.

The reason? The Moral-Hazard (and the Republicans, of course). The idea behind this moral-hazard is that we’ll take advantage of what we get for free, and therefore not use it wisely. Then in 1968, the economist Mark Pauly argued that this hazard plays an “enormous role in medicine”. That is, and some people in our goverment would like us to believe, that if we all get universal healthcare like Canada, Germany, Japan and other industrialized countries, we’d make stupid choices such as… going to see doctors too often!

More: there are two models of insurance, the social-insurance where we pay similar fees and everyone shares the burden, or the actuarial model - which is a very obvious Republican model where you pay for what you need. So let’s say you got bad genes, then, well, tough luck. Bush’s administration’s Health Savings Accounts is of the latter model, and one to minimize moral hazard.

So, the Health Savings Accounts is apparently a bad idea, and I would rather have a universal health care coverage. But this article does not give me much more than some survey on a couple of theories. I thought from the first couple of paragraphs that I’m going to find out where the money is going to and how we got to where we are, and not just another poke at our administration. The problem is a lot more complicated than just, ok, let’s all agree on having a social-insurance and we’ll all live a lot happier. How about the drug industry and how the doctors are issuing more pills than ever? Or how the health industry is suspiciously slow in adapting technology, which would save tons of money in administration? And more importantly, what can we do about it?