WSJ today has the 2009 number on healthcare expenditures in the US: $2.4 trillion.  They check it in terms of an hourly rate of $282 million, which is a neat way of looking at it, but I prefer to compare it to world GDPs.  According to the CIA's World Factbook, if healthcare were a country, it would be more economically significant than the entire output of the UK economy.  Or, even if the entire population of India and Australia worked hard all year, their collective efforts combined wouldn't equal what Americans spend on healthcare in a year.

I've long maintained that I'm not smart enough to figure out the answer to the unsustainability of US healthcare, and to a certain extent, healthcare reform is as much my problem to solve as economic reform in India is a problem for the average resident of New Delhi.  The smart people in Washington can't fully get a handle around the problem, fraught as it is with emotional baggage.  Bill and Hillary didn't fare much worse--healthcare is a humbling adversary.

Jared Diamond argues that what brings down societies is not war or plague but the lack of sustainability of their lifestyles, and he gives examples in his book Collapse. 

So how do you reconcile the reality check of sustainability with the politically hazardous task of reforming, if it were a country, what would be the sixth largest economy in the world?  Perhaps we should have one guy sitting in a room somewhere for a year, and tell him, ok, you walk in with $2.4 trillion in 2010, and you find a way to walk out with a sustainable number in 2011 and beyond.  He would be a convenient political scapegoat, universally reviled.  If someone didn't assassinate him first, that is.  It would have to be someone unique, like a guy that has an MD and some other degree in health care finance or administration.

By the way, here's a lecture by Jared Diamond that I found; I've seen him on TV and he's an awesome speaker.