Thomas Sowell argues that proponents of government medical insurance use a lot of marketing language and make few arguments.
A cynic is said to be someone who knows the price of everything and the value of nothing. If so, then it is political cynicism to point to other countries that spend less on medical care, including some countries where there is “universal health care” provided “free” by their governments.
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There are more than four times as many Magnetic Resonance Imaging units (MRIs) per capita in the United States as in Britain or Canada, where there are government-run medical systems. There are more than twice as many CT scanners per capita in the United States as in Canada and more than four times as many per capita as in Britain.
Is it surprising that such things cost money?
I was surprised and irritated when I heard the president say he could cut wasteful spending in Medicare by eliminating unneeded tests like MRIs and CT scans. The scans he said were wasteful were those that came back negative. So if a problem wasn’t found, the test was a waste of time?
The real solution to this is to put all the decision making in the hands of doctors, patients, and Christian neighbors who would be willing to help people pay for the care they need.
I suspect it’s a plan to save social security. There are two factors killing it:
1. Not enough young workers. However, to fix this problem you’d have to outlaw things like abortion. Also, the solution won’t help for a couple of decades – and our lords and masters don’t think for that long term.
2. Too many retirees. That is something socialized healthcare can deal with.
I only wonder how long it would take to fix up the country once they’re gone. The way the economy is going, I don’t see an Obama victory in 2012.
I was surprised and irritated when I heard the president say he could cut wasteful spending in Medicare by eliminating unneeded tests like MRIs and CT scans. The scans he said were wasteful were those that came back negative. So if a problem wasn’t found, the test was a waste of time?
I hate to defend Obama, but this is not quite as stupid as it sounds. Imagine that under a set of circumstances an MRI comes out negative 99.99% of the time. In one case out of ten thousand, it comes out positive. On the average, this one diagnosis prolongs the patient’s life by a year. Should we do ten thousand MRIs, or should we use the same resources to, for example, start screen more people for heart disease earlier?
The only problem is that I don’t trust the politicians to honestly evaluate the tradeoffs. I don’t trust medical insurance companies either, but at least we can pit them against each other and sue them. Politicians would be difficult to pressure.
If people had to pay the cost of the tests themselves (and not at the abominably high rates “negotiated” between doctors and insurers), then the problem would be solved. Also, for those who had need but not means, the church or private charities should step in. Sometimes they do a better job than governments or markets.
I agree with Loren, because the way I see it, there’s too much of a disconnect between the money going out of people’s pockets and what they see as the price (not the cost) of healthcare.
When my employer “gives” me health insurance (employers don’t really “give” anyone health coverage; it just seems that way), and that covers every little thing under the sun, well, why not use it for every little thing? It’s not costing me anything, is it?
Well, pardner, it actually is costing you; you just can’t widen your view enough to see that.
If you think the rates doctors charge insurers are abominable, imagine how high they would be if the doctors charged the patients directly. Insurers have the negotiating leverage to get bulk discounts. Individual patients do not.
Ori, that’s a good point, but doctors with sense and/or compassion would understand that they can’t overcharge their patients. If most people can’t afford MRIs, then something needs to change to make them affordable. Group leverage is one way. Private and corporate charity is another. Doctors and hospitals will (and they do) care for some for free or very little. This the best way to address high health care costs.
Ori has a point: Physicians often pass those inflated costs on to patients who don’t have health insurance. (I shudder to think that I would have had to pay $27,000 for my emergency appendectomy, which is what my doctor charged Aetna.) However, I have relatives who use doctors that run cash-only offices. Their services certainly cost more than a co-pay, but they’re cheaper in an absolute sense, and the service is better. Paying out-of-pocket isn’t a perfect idea; people will continue to get catastrophic illnesses like brain cancer. But price rationing, in general, seems better than bureaucratic rationing.
A few weeks ago I got a call from my husband saying he was being taken to the hospital because his blood pressure was out of control. I then got to see him in the hopital hooked up to all sorts of monitors. Two negative stress tests later, I can breath again.
And while we haven’t gotten the bills yet for our part of the tests, I will endeavour to remember my relief while making out the checks.
Phil, the problem is not that doctors lack in sense and compassion. It is that a lot of the miracle cures we have now really are that expensive. Every new drug has to pay not only the one billion dollar bill for its own development, but the bills for a huge number of failed drugs. A low end MRI machine costs a million dollars.
Doctors and hospitals can only be charitable towards those who really need it if they can charge the rest of us high bills. Something could change, but I’m afraid that the change might be less MRIs and less new wonder drugs.
When I say doctors, I mean the whole industry really. Many things will have to change, and one way it may change is how you describe it. Still, less wonder drugs is a big possibility for socialized medicine, because politicians want to talk guilt and greed over cost and viability.
Socializing medicine will definitely mean less wonder drugs. As it is, the US is subsidizing medical research for the rest of the world. If we didn’t do it, nobody who is sufficiently rich would.
However, I don’t believe medicine will stay socialized. Nationalized healthcare is mediocre healthcare. This means that rich people, such as congress, will want a private system. Naturally, as the government system declines further, the private system will attract more and more people. Eventually it would be like military veterans – only the poor ones go to VA hospitals.
IIRC, in Canada it is illegal to have a private medical practice. But I doubt that would fly in the US.
WSJ has a good article about how Canada has begun to privatize some of its health care.