Friday, June 19, 2009

More Health Care stuff

There are More Ways to Go Wrong Than to Go Right.

Megan McArdle makes a very good general point in her post on the illusion that socialism will reduce health-care costs:

We have been trying to control health care costs since the 1970s made it clear that Medicare was going to get really, really expensive.  And any idea that you care to name, from comparative effectiveness research to healthcare IT to preventive medicine . . . these have all been on the table for more than thirty years, under one name or another.  They haven’t happened.
 
The answer that those promising magical cost reductions need to ask is “Why haven’t they happened?” and “What has changed to make them feasible now?”  But when I ask this question, I get angry demands that I put forward my plan for cost control, rather than merely critiquing everyone else’s.  This seems rather like demanding that I put forward my design for a perpetual motion machine before I am allowed to point out problems in the US energy market.

I was reminded of this style of argumentation by Harry Angstrom’s comments in my previous post, where he makes this exact argument. In thinking about it, I realized that a lot of debates with leftists often come down to this type of, “I have an idea and you don’t, therefore I must have the best plan,” argument.  [read more]

On the other hand, my cynicism has reached a level where, when a plan is presented ... see next post.
rass

4 comments:

Anonymous said...

We all know that the "best plan" 99 times out of a hundred is for the government to do nothing and let the market sort it out. We are also well aware that the reason that costs are out of control in the first place is because of government intervention. Of course, the idea that anything can ever possibly happen anywhere without the government's direction will never, ever occur to Obama and his ilk in a million years.
GrinfilledCelt

JMcD said...

With the New ObamaHealth Plan, The poor, prisoners, and illegal immigrant's health care will be free. The poor and prisoners will of course have to abide by a waiting list...Anyone professing to have a religion will be told to pray for health for at least 5 years THEN will be eligible to go on the waiting list.....The wealthy, (those able to afford bus fare after taxes) will go to Canada for their health care....Anyone not covered by the above will be provided jobs in government so they wont have to worry about the petty sh*t.

Anonymous said...

"..the 1970s made it clear that Medicare was going to get really, really expensive."

The reason of course is that the flood of new Medicare money itself drove prices up. Medicare not only increased demand, it replaced payment by individuals with limited resources by payment by the near bottomless pit of government money.
Fees and prices that were formerly kept at reasonable levels due to limits on the amount people could actually pay were suddenly free to increase as fast and as far as lobbyists could get the fee schedule increased. All that was lacking were more organized and sophisticated ways for medical care providers to separate the government from bigger and bigger chunks of money. And that didn't take long at all.

Boneshaker

tom said...

Boneshaker,
The reimbursement of fees for service by Medicare and Medicaid have been reduced for three years running. They are less than 'reasonable and customary', the catch phrase used to describe what insurance companies will pay for specific levels of service.
Problem is that in the near future there will be less Docs that will take on those patients. WJC actually paid some medical colleges to cut back on their class size. Perhaps at the urging of the AMA, which does NOT represent the majority of Docs.
Fee for service, with rates published and agreed on, no paperwork to get 'approved' by a paper-pusher, "simplifcate and add lightness" would make things less costly.
OTOH, if we are currently paying for health care for those that do not have 'insurance', they why should it cost any more? The 'hidden costs' that the D's like to parade around are already being paid, so why not tell them to STFU, we don't have a problem...

tomw

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