One reason we’re getting nowhere quickly in health care reform is that Bush is focusing primarily on health savings accounts and “consumer-directed health care,” which basically puts people in charge of making their own health care decisions. This is a ridiculously terrible idea for many reasons, not limited to the fact that 1% Of Americans Account For 22% Of Health Care Spending , and the top 5% account for basically half of health care spending.

These are the people that spend 10 months in the ICU, or have 23 vascular surgeries for peripheral vascular disease. These are not people that are trying to decide whether to get that lab test or that colonoscopy. These people are not using health savings accounts. So Bush is putting all his effort into these accounts, when, very likely, it might put a teeny, tiny little dent in health care spending. The wool’s pulled over his eyes for the giant elephant in the room.

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