Tuesday, January 23, 2007

Medical posturing from the ivory towers...

President Bush's purported health insurance SOTU proposal has been leaked and the economist-blogosphere is buzzing with instant analyses. I've read about 10 and not one - that's right, ZERO - seem to address the fundamental underlying problems:
  1. Providing all the medical care we now have to everybody.
  2. Including the growing number of "uninsurables" (thanks to rapidly improving screening such as genetic testing) outside groups or self-employed.
One can only assume that most academic economists have pretty darn good coverage through their universities, and have never confronted the issue of being able to pay for insurance but being turned down.

Health insurance is simply a way to hand the bill around. It does nothing to tackle the hard problem of how many liver transplants a person is allowed, or whether to do bypass surgery on a 90-year old or how does a 25 year-old independent trucker with genetic markers for MS get coverage.

Our problem is not just medical insurance. It's paying for all the medical care we now can provide, such as drugs and procedures never imagined 10 years ago. And for how long? The expenditure of increasing portions of our economic output in the final few months of lives is a growing problem that nobody want to tackle, even as it threatens to consume us.

13 comments:

brian said...

I think Tyler gets it:

http://www.marginalrevolution.com/marginalrevolution/2007/01/the_bush_health.html

John Phipps said...

brian: Thanks for the link. Still we have to deal with the fact that human mortality has hovered very close to 100% for a long time, and throwing resources at it doesn't seem to make much difference.

There has to be a way to decide what enough health care looks like, no matte who is paying. Letting the market decide seems harsh, but in the end, that's what happens.

Patrick said...

I'm not sure what the answer is either, but when I pay $525 a month for coverage for me, my wife and 4 kids and we still get doctor bills. I'm not sure what I am getting for my monthly premiums.

It would be nice to reduce the regulation on healthcare, that would probably drop it some...

Patrick

LakevilleDad said...

Yes, Bush's plan just makes it easier for companies who do not want to provide health insurance as a benefit. What are these people going to do if they get health insurance in the individual market and then get a serious illness -- the insurance companies don't make money off sick people, they will rate them up and move them out. Good article at http://www.healthinsurance.org/blog/2007/01/bush-again-to-show-failure-to.html

John Phipps said...

Thanks for your inputs, guys. It is hard for me not to look at GB or Canada and their much maligned government health system. Grotesquely bureaucratic and slow, it still seems to deliver better health results than our much more expensive model. Evidence suggest access to health care may be less important that actual quantity or technology.

Making basic health care free is problematic but the wealthy will continue to fund a side-by-side private system to satisfy the demand for health services.

At least in Britain the emergency room are for emergencies. And the insurance system doesn't siphon off as much money that could go toward actual health care.

National health would also change employment. Too many people work at jobs they despise just because they have a sick family member. I think empowering employees like that could do much to change the dynamics of wages, as well.

Anonymous said...

Ultimately, whether social medicine ever invades our economic system or not, it seems to me that at some point we are going to have to address the fact that death is eminent! We will die some day! So, once we accept that, and some probably never will, we will need to use a certain age factor as a switch to trigger when it is prudent to reduce medical investment into that individual...and that my friend is probably why no one wants to address this subject. Other problems also would become bigger problems if social med. ever takes hold...for instance illegals. Just some food for thought.

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