Monday, July 20, 2009

Lowering Healthcare Costs: A Question

When has government involvment ever lowered the cost of anything?

The Hammer


12 comments:

Vinny said...

Electricity and transportation.

ChrisB said...

I gotta disagree. My state has experimented with electricity deregulation. It's not a pure market system, but it has lowered costs.

But that's not a good comparison for healthcare. Government may tell the electric company what it can charge, but you are the one who has to pay it -- so when they whine that they need more money, the govt usually lets them charge more.

In healthcare, govt will be much more involved than just setting the prices, and since it will appear free to you, you will want more while govt will be the ones saying they can't afford it.

I can't imagine what you mean by "transportation."

Vinny said...

Are hammers a good comparison for health care?

In any case, I was not talking about the recent past although California's experience with deregulation of electricity has been a real horror story for consumers.

I am talking about rural electrification in the first half of the twentieth century. Electric utilities claimed that they could not provide electricity at a profit outside the cities, however, when pushed to do so by the government, they ended up making lots of money. With new markets for electricity came new markets for appliances and more electricity usage.

By transportation, I am talking about the network of highways and railroads that never would have been built without government backing. The ability to move goods and people cheaply created economic opportunities for the whole country.

Markets are wonderful things but our economy never would have reached the point it has without the government stepping in at key moments.

ChrisB said...

"Are hammers a good comparison for health care?"
Given our govt's track record? Probably?

"Electric utilities claimed that they could not provide electricity at a profit outside the cities, however, when pushed to do so by the government, they ended up making lots of money."
Government stepped in and did what private entities didn't have the guts to do -- they invested where there was little expectation of profit, creating the possibility of profit.

And this is like the current situation how? The insurance providers and healthcare providers are widely demonized for even wanting to make a profit. The systems that have been offered will all push private entities out of healthcare entirely.

What we will end up with is almost everyone lumped into one program. Consumers to whom medical care will appear to be free, will use healthcare resources with abandon. The government will be forced to limit supply and payments.

The former will result in rationing and NICE-like systems that put a dollar value on your health, life, and comfort. When you become too expensive, you're screwed.

The latter will result in increasing financial burdens on healthcare providers. They will be under continual pressure to work with less staff, less equipment, and less exacting standards. See Great Britain with its record of secondary infections from hospital stays.

With less money in the system, and no profit motive, there will be no reason for anyone to invest in medical research. Private sources will dry up, and government sources will be overstretched. In the end, the last source in the world for meaningful health care research will be gone. In a generation or two, perhaps China or India will take our place.

Vinny said...

Your question wasn't when the government had lowered costs in a situation like health care but when it had ever lowered costs.

I have no problem with people wanting to make a profit. I just recognize that the profit motive hasn't produced a viable healthcare system and is unlikely to do so.

ChrisB said...

"when it had ever lowered costs."
And I'm not sure you gave such an example. As you point out, things progressed where they might not have without govt involvement, but it wasn't government but supply and demand that brougth prices down.

"I just recognize that the profit motive hasn't produced a viable healthcare system"

Huh? For all its flaws, our system is still better than anyone else's.

Vinny said...

On what measure is it better? We spend a higher percentage of GDP with worse coverage and worse results than countries with socialized medicine.

ChrisB said...

Please explain "worse coverage."

"Worse results?" You mean like how the US has better cancer survival?

Vinny said...

How about you explain what measure you are using to claim it's better and what countries you are comparing it to.

ChrisB said...

Shouldn't you ask the derSpiegel guy that?

WebMD

about.com

Lancet via Economist

Vinny said...

"There is no question that being uninsured is unfair and brutal, nor that the lack of universal health coverage is the most pressing problem of American domestic politics. The true disgrace of American health care is that infant mortality is higher than anywhere in Europe."

ChrisB said...

Shall I assume you're quoting one of the above articles?

"The true disgrace of American health care is that infant mortality is higher than anywhere in Europe."

I'm not sure that's entirely true, though if it is there are certainly plenty of explanations. But statistics can be reported differently. Specifically, iirc, the US includes babies born sick (very premature) in their stats where Europe doesn't.

I'm not sure I'd agree with "unfair and brutal," but it's a horrible state (for those who don't choose it, of course). It's not what anyone wants.

But everyone seems to want to pretend that the only option is a single payer system. You want to move from life's lottery to the governments? To the equal distribution of misery?

Why support a system that has not worked anywhere? Find something else. Either try to find a compromise solution like my most recent piece, or try to find a new solution. The best answer will probably come from someone who takes off on a completely new direction, an approach no one has ever thought of before.

Be that guy.

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