Some Day We'll Have Floppy Discs
John Cassidy in The New Yorker believes nationalized health care is basic justice. At least he admits it'll cost a lot, though then again, he figures it's such a noble cause it's okay to lie about that.
But John, what if it doesn't improve health care? What if (a friend gave me this analogy) 40 years ago, the country passed a law that either everyone had a computer, or no one had a computer, and that no company was allowed to make a profit selling computers. We'd probably all still be enjoying our Commodore 64s. Same thing for phones, TVs, MRIs, etc. (except there might not be MRIs).
Once the government passes the health care bill there's no turning back--as Cassidy understands. If progress is slowed in medical innovation, and this is a likely outcome, countless people (around the world) will have worse health care, no matter how good (or bad) their insurance is. But at least they'll die in hospital beds, paid for by the state (i.e., themselves).
posted by LAGuy @ 12:12 AM
13 Comments:
I am more than happy to trade a slower rate of innovation for a slower rate of cost increases. The current cost curve is unsustainable. Moreover, basic preventative care and chronic illness care provide the greatest opportunities for increased public health, not the next MRI machine.
QGuy does not get it. Take the govt regulation out and you will "bend the cost curve"
AAGuy
Well, Hell's bells. Put QG in charge of health care. Good thing he doesn't have to raise capital and compete in the market, or we might all be denied his fundamental rightness. Now we're going to get it, good and hard.
So QueensGuy is still talking up preventative care and chronic illness care? The government's been trying that for decades. Has it worked? (Doesn't that imply something about their efficiacy?)
The funny thing is, even if considerably better results could be achieved, it has nothing to do with a government takeover of medical care. No matter how much you could do on that end, you'd still see everyone, and I mean everyone, getting worse care if medical innovation slows. Since people will still continue to get fatal diseases, chronic and otherwise, this should be a prime consideration, not something laughed off.
"I predict that within 100 years, the best health care will be twice as powerful, ten thousand times larger, and so expensive that only the five richest kings of Europe can get it."
WOw-the anono-mites really react when their fundamental beleifs ger challenged. Anyway, if you accept the dubious premisethe innovation being stifled is the way health care insurance is delivered- not medical research- yes they are related but they are quite different things.
It's not a dubious premise, it's a fairly predictable result. Free markets leads to greater choice, while command economies and centralized planning lead to more control and less choice.
This isn't really a prediction, it's been seen over and over, including in the field of medical care. (And I'm not even getting into the government desire to "bend the curve" by cutting costs.)
I'm no fan of the bill, but I'm not sure your analogy is correct.
To the best of my knowledge (and I haven't read the bill!), the bill doesn't set or cap the prices charged by doctors, hospitals, pharmaceutical companies, or creators of medical equipment. Instead, it controls the prices charged by insurance companies.
Surely the companies who invented modern computers are analogous to the providers and creators of medical care, not to the insurance companies, who are just middle-men.
Of course, if the insurance companies find that under the new regime their profits shrink, and they aren't legally allowed to raise premiums, they can attempt to reduce the amount they will pay doctors and hospitals. By this means, the guns could be redirected at the providers and creators. But if this happens, I would expect the government to further regulate things.
The key question for me is, what has been the net benefit and hurt of having a very small number of insurance companies act as middle-men for 99% of all medical transactions in America? These companies have, in many ways, capped medical costs for their own motives. Sometimes it's in interest of standardization (e.g., doctor X can't charge more for an appendectomy than the price that insurers consider to be the "standard rate). Other times it's a cap (denying a sick person expensive treatment that has a 20% chance of saving their life).
Has that curtailed innovation? I imagine it has.
I don't know, a priori, that government regulation of these same choices would be more stringent. It might actually turn out that government bureaucrats are not as good at cost-cutting as insurance company employees. If so, wouldn't "innovation" actually do better under a single-payer plan than under the current insurance company regime?
As for the bill, no one's read it and no one knows what the final law will be, and how exactly it will apply. I'm going on what those who support the bill want.
"Insurance," for better or worse, has become the source through which consumers pay for most of their private medical care. Government becoming the main insurer (or requiring insurers to follow along its lines) amounts to government control of the medical world. I'm not saying there won't be any freedom for hospitals, doctors and others to make decisions, just that they'll be jumping to the government's tune.
Even if you believe our government won't be able to successfully cap the money they spend on medical care, and will act in a relatively efficient manner, it's still questionable if they'll be that good in predicting where the money should and shouldn't go.
We've already seen that a disproportionate amount of medical innovation around the world is done in (and for) the United States. Others even free ride on it. If this final price-setting market is destroyed, I don't see good things happening.
(Let me add I do support a lot of ideas for reform, in medicine and in the insurance industry. Just not generally the kind proposed by those who think a single payer system is what we want.)
AAGuy, you're right, I don't get your point. Do you want to take all government regulation out, or just start with the Medicare and Medicaid part? Last time I checked, those on the right are using as their primary fear-mongering technique the threat to seniors that cost-containment would equal cuts to Medicare. Besides Ron Paul, who's on your side in this?
"AAGuy, you're right, I don't get your point."
If I may speak for him, his point is very obvious. The government doesn't allow there to be any competition among insurance companies, and then everyone is shocked when prices are high. Let them compete between states and we'll "bend the curve."
As for fear-mongering, it takes a lot of nerve for anyone who supports the Democrats, whose favorite technique is to claim we'll die in the streets without their help, to accuse Republicans of overdoing it.
Whether republicans are "overdoing it" is not the point, anon. The idea is that they're almost universally opposed to (or claiming to be opposed to) reforming the very largest part of government involvement in health care. I want to know if that's the part AAGuy is referring to. Cross-state sales of insurance policies would be wonderful, and I wholly support it. That, however, is far from a panacea, according to the CBO and most health economists. Like malpractice reform, it's a great idea, and will help at the margins, but is far from sufficient.
QGuy,
One of the problems with republicans is they make arguments that free market people would never make. I am not in favor of the current structure of medicare and medicaid as a starting point in reforming healthcare. There are numerous goals that the current plans being touted by democrats purportedly achieve: lowering health care costs, universal access, removing the pre-existing conditions denial.
None of these appears to be well done in the plans as laid out but clearly the least likely acheived goal would be cutting costs.
I thought the 8point plan laid out by the chairman of Whole Foods which was a liberal/moderate plan was pretty good and easy to achieve. I think incentivizing private health insurance at a greater rate than employer-paid-for insurance might be a start to lowering costs. there are a lot of solutions that might help. The dems seem to desire a huge new bloated bureaucracy.
AAGuy
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