Today…right now…this moment…no macro economic system will do squat for him. Nor will any discussion of the various merits of different systems. Nothing will help other than getting to a doctor now.
So, moving on…
The basic flaw in most health care systems is in the fact that the consumer has no incentive to make rational choices. The consumer is separated from the payer. Hence the consumer doesn’t care how much he is consuming since he doesn’t pay the marginal cost.
If he has drug coverage, he doesn’t care if hegets a name brand for $20 or a $5 generic. He doesn’t care if the doctor orders 100 blood tests or 20. If he were paying the marginal cost, he would be concerned because he pays. he would ask questions. he would make decisions.
One might object that the consumer pays for coverage, but that is very different from making a rational decision about each incremental purchase of care. He makes that type of rational choice about everything else he buys, but not health care.
I think wer have a fine health care system, but it has been twisted out of shape by government. For example:
- It is illegal to buy health insurance across state lines.
- Government mandates conditions that all policies must cover. .
- Government limits the geographic area within states where a company can operate.
- Government limits the amount that premiums may vary from one person to another.
- Government allows malpractice tort suits that push up costs.
- Government mandated Medicare problems in small areas are fixed by applying unnecessary rules to the whole country.
The result? Premiums for a 25-year-old in New York are six times what the same guy pays in Kentucky for the same coverage.
I can buy any insurance I want across state lines except health. That greatly limits my options. At the same time,people complain that there are too few companies in their area.
Companies can’t design policies to fit individuals. They must force coverage that consumers don’t want.
In a nation of 300 million, we can’t form pools to meet specific needs. Why make all policies cover mental health when many don’t want the coverage? Those who want it can surely find a pool in a nation of 300 million.
In short, insurance cannot be structured to provide what people want. It is structured to provide what various lobbying and disease interest groups want.
Those 45 million uninsured Obama talked about? 10 million are unmarried, between 20 and 30, with incomes over $50,000. They choose to be uninsured bacause 1) they are healthy, and 2) governmant has so screwed up policies that the cost makes no sense to them. The risk/reward ratio is irrational.
On the subject of the 45 million… Whare did that come from? it was a snapshot survey taken by the Commerce dept in 2007 asking igf someone was uninsured at any time in the last year. It is a completely inadequate basis on which to make national policy. We don’t have anything else. So, we don’t even know what the problem is. All we hear is poor Mrs. Jones in Cleveland who has condition X.
So, what to do? Lift the government restrictions and let the market provide what people want and need. Let companies offer low cost policies with high deduactbles. Let them offer medical savings plans. Let them sell women policies that don’t include prostate cancer.
Laser eye surgery and plastic surgery are excellent case studies .Neither is coivered by insurance, but both have made exceptional strides in the past thirty years. And costs have come down while all other medical services have gone up. Why? People pay out of pocket. It isn’tinsured. They pay attention to what they pay and what they get. The industry had to do better. It did.
Note Tom Daschle was Obama’s first choice for secretary of HHS. After leaving the senate he wrote a book on health care. He said we had to limit the introduction of new drugs, technology, procedures, and treatments so they didn’t contribute to cost increases. Think about that. If you have Parkinsons, tough luck. No more research. Live with it. Diabetes? Shut up and take your shot. No new research. This is the common wisdom among the folks that want to institute national health care.
Suppose that had been policy for the past 30 yerars. No MRI. No artificial knees. No artificial hips. No high blood pressure medicibne. No cholesterol medicine. Go off and die so we don’t have to pay for you. Keeping the new stuff out is a hidden rationing that most fools will never know about.
I don’t think any of us are smart enough to come up with a comprehensive solution. We haven’t done that with anything, why expect to do it with health care? Get rid of government meddling and takesimple and incremental steps.
Enough. I can go on forever. Bla Bla Bla…