COST: Can't Buy Us Love, But $700 Billion Could Buy a Lot in Health Reform

What would you do with $700 billion? (Aside from buying the fabric ($2.10 a yard) needed to make 3.6 billion golden parachutes.)

Here at the New Health Dialogue, we like to talk about how a quality health care system will actually save us money. But while watching the ups and downs of the Wall Stree bailout plan all week, we couldn't resist indulging in a little health care spending fantasy. So we asked our director Len Nichols how he might spend $700 billion.

He suggested we start by covering the uninsured. We looked into it and $150 billion seemed reasonable based on work from the Commonwealth Fund. When we told Len he still had money left to spend ($550 bn) he asked how much radical reconstructive surgery on Chris Carpenter's elbow would cost, so we decided to move on to our deputy director, Julie Barnes.

Our resident health IT expert, Julie suggested financing the full implementation of health IT in our nation's hospitals and doctors offices ($115 bn). She'd use the rest ($435 bn) to buy everyone in America not one, but seven, iPhones ($200 a piece)—you know, just in case you drop your smart phone in a lake.

Our colleague Joanne Kenen suggested gifting a gym membership ($750) to the 63 percent of Americans who are overweight or obese ($142 bn). She'd use the rest ($293 bn) to combat childhood nagging/obesity and buy a Wii Fit for every child (and manchild) in America.

Elizabeth Carpenter—SCHIP expert by day, Fashionista always—would fund SCHIP for the next decade ($56 billion). Of course no plan for comprehensive coverage would be complete without the correct footwear. Ms.Carpenter thought something blue would do. Are 250 million pairs enough?

Sarah Axeen also appreciates a good shoe, but she's her grandmother's favorite for a reason. She'd take the remaining money ($237 bn) and fill the Medicare Part D donut hole ($3051 in 2007) for all 24 million beneficiaries ($73 bn). She'd also buy each one of those beneficiaries a four-year supply of Krispy Krème donut holes ($4.19).

All that sounded good to Paul Testa and since his doctor decided to stop practicing in D.C. (thanks for calling!) he'd use $14 billion to pay off the med school debt for 100,000 new doctors choosing to go into primary care. Even after doing all that, he'd still have $150 billion left. Since it's 5 pm on a Friday before the first presidential debate, he's deciding between 188 million magnums of Cristal or 150 billion forties of Magnum malt liquor ($1.49 each). And if there's any spare change after we've fixed health care, we'll use it for health wonk retraining.