"There is always a philosophy for lack of courage."—Albert Camus

Wednesday, January 25, 2006

Ask an Economist

Robert Samuelson has a very balanced look at the healthcare problem.

You'll just be smarter and better informed for reading it.

9 comments:

Tlaloc said...

"On a grander scale, that's our predicament. Americans generally want their health-care system to do three things: (1) provide needed care to all people, regardless of income; (2) maintain our freedom to pick doctors and their freedom to recommend the best care for us; and (3) control costs. The trouble is that these laudable goals aren't compatible. We can have any two of them, but not all three."

Conveniently the order he mentions them in is also the order of their importance. Provide 1 first. If possible provide 2 next. If 3 can't be done that's fine, because it was the bottom priority anyway.

The Classic Liberal Anonymous said...

Most workers don't see the full costs of their health care.

Ie, price illusion.

Price illusion occurs when the perceived price of something does not reflect the true cost of that good or service, and creates instead the illusion of low or even zero cost.

I can't tall you how many times I've heard "...it only costs $15 co-pay to go to the doctor, its cheap!"

Just like with price controls, there's no such thing as a free lunch.

James Elliott said...

I see we have some certain someones who'll be cheering the "HSA" portion of the State of the Union...

The Classic Liberal Anonymous said...

Not to be misunderstood ...

I support a "safety net" of some kind for those in need.

For the rest of us, there has to be some incentive to economize. In Canada its called a long freaking line; in a free market it is called "you get what you pay for".

Clearly in the USA, we have neither.

Disclaimer: I have always had insurance premiums taken out of my paycheck, similar to SS and income tax. Thus, I have a perhaps tainted view of how people typically pay for insurance. I am sure there are many (retirees perhaps?) who have a better feel for what they are paying.

connie deady said...

Nice article. I agree with it. The debate of course ought to be which of the three are priorities.

Certainly cost figures in use of medical care. The problem is that the poor may not get care they need and those with insurance get lots of care they don't need when cost is a consideration.

Like TCLA I pay for my health insurance out of my pay, in that one of the people I consult for includes us in his blue cross group on a Cobra and deducts it from the pay. It comes to the tune of about $1100 a month, so I'm pretty much in touch with how much it costs me.

I go to a family practice that extensively uses physician's assistants. Greatly works for me, because most of us go for check-ups, colds and such.

I think we need to find more types of ways to make level of care appropriate to medical need. Do I need to see a doctor to give me the same prescriptions I always get when my cold hangs on for more than a week. No. PA works fine for me.

Hunter Baker said...

I have a great feel for what healthcare costs. I've had absolutely terrible student insurance on a couple of occasions, the last when I had two kids. It's no picnic. You fight with company employees a lot. You pay more. There is no sense of customer service, unless you get your institution involved, which I ultimately did.

I honestly think the invention of health insurance several decades back was a real mistake. It's no accident that the house call died out right about the same time insurance took hold.

James Elliott said...

Amount of money the US would save annually on paperwork if it switched to a single-payer health care system: $161 billion.

Percentage change since 2000 in average amount U.S. workers spend on out-of-pocket medical expenses: +93.

JC said...

Conveniently the order he mentions them in is also the order of their importance. Provide 1 first. If possible provide 2 next. If 3 can't be done that's fine, because it was the bottom priority anyway.

That's a bit of an oversimplification, isn't it?
The "order of importance" is a matter of your opinion. And just how unimportant is the cost of health care to you? Would you like to see our government spending $100 billion? A trillion? Ten trillion?
Of course costs matter, the question is "how much."

Tlaloc said...

"That's a bit of an oversimplification, isn't it?"

No not really.



"The "order of importance" is a matter of your opinion."

Sure. If you have an opinion that justifies the comfort of the rich and letting the poor suffer and die I'm curious to hear it. That's the only way you can put prioritiy (1) as anything but #1.



"Would you like to see our government spending $100 billion? A trillion? Ten trillion?"

Yes absolutely if that's what it really cost, but of course it doesn't. See our nation has the most expensive and simultaneously one of the worst (in the first world) health care systems. We can easily do far better with universal coverage for less than we spend now.



"Of course costs matter, the question is "how much." "

Alright how much are the lives of people worth to you? You are claiming that they have a dollar value, well, what is it? See how the problem suddenly takes on a new significance when you try and translate vague economic ideas into an actual price tag to stamp on a human being?