By Russ Nelson, on April 27th, 2011
People are bringing up the point that people simply don’t shop for health care. That we’re not consumers. Usually that people are non-economists, like some ER doc who thinks that he had to study for 8 years to become a doc, but that economists are just people with opinions. Or like Paul Krugman, who gave up any claim to be an economist years ago.
To these people, I say: just *try* to be a consumer. Presume that somebody actually could act as a consumer, and go buy their health care. An honest seeker after the truth will quickly realize that so few people pay for their own health care that prices aren’t available. Go into a doctor’s office and say “I’d like a 20 minute visit with the doc — how much will that cost?” and the staff will be flabbergasted. Chances are very good that they won’t know what to tell you. This could make the point that people who consume health care aren’t consumers (although it’s hard to state that relationship without using the “C” word). I think, instead, that it makes the point that people are consumers, but they’re not purchasers.
By B.P.T., on February 13th, 2011
By B.P.T., on February 8th, 2011
By Christopher Briem, on January 20th, 2011
Daily Beast has Pittsburgh at #11 on a list of most insured places in the nation.
So the question why comes up when this stat pops up and it’s pretty simple. A combination of Pennsylvania’s CHIP and a lot of folks covered by Medicare together add up for us. Pennsylvania pops up disproportionately on that list mostly for the same reasons. York, PA is 7, Scranton 13, Harrisburg 22, Allentown 25.
By Russ Nelson, on March 29th, 2010
Health care in the USA is completely broken. Health care is a difficult problem, to be sure, but I think it’s clear that we’re currently solving it very badly. Two problems with health care: One is that people expect everyone to have the same health care as a rich person, even if they’re not rich themselves. Another is that health care, not being exposed to the discipline of the market, is very expensive. If everyone gets the same health care as a rich person, then there is no pressure to create more frugal health care.
Health care then being expensive, everyone expects somebody else to be paying for their health care. This creates bizarre solutions. For example, the Canada, health care is paid by the federal government. In order to hold down taxes, access to health care is limited; typically by waiting periods. Or in the USA, most working people have
their health care paid by their employer, except for a very small deductible. This makes it difficult for employees with health problems to switch employers. The government has created a ham-handed solution which permits former employees to continue their health insurance by paying the premium out of pocket.
Health care is important, without doubt. So is food (insufficient calories reduces your resistance to ordinary infections), but we generally don’t expect everyone to be able to dine on caviar and steak every day. Many different kinds of food are available in many different venues and preparation styles, at reasonable prices. Yes, the poor may need to dine on beans and rice, but except for the most indigent, everyone can get enough calories, protein, and vitamins to stay healthy. Health care could be the same way; with cheap, worthwhile health care being available to everyone at affordable prices. We have chosen a different path; much to our detriment.
By Thomas Knapp, on December 9th, 2009
Simply put, it’s like this: If you’re a member of Generation X or Y or whatever the hell they’re calling the various post-Boomer generations these days, you are to be boiled in hot water until you’re nice and tender and your meat and bones have separated.
The insurance companies receive the meat (“individual mandate”).
The Boomers get the bones (“Medicare buy-in”).
Beautifully efficient as cannibalism schemes go, don’t you think?
Unlike the previously considered “public option” — which might have had loopholes through which a clever youngster could have navigated his or her wallet to some semblance of safety — the “Medicare buy-in” automatically gets the older, higher-risk types out of the insurance companies’ way while pushing the younger, lower-risk population right into their gaping maws with the “individual mandate.” Lower risks! Higher profits!
And watch for ObamaCare’s approval ratings to jump way up since that older, higher-risk group — the over-55 set, which almost certainly constitutes an absolute majority of voters — gets its health care subsidized by the younger, lower-risk group, too (through the payroll tax system, which is already tried, tested and and as escape-proof as anything the government’s ever come up with … just wait, it won’t be long before the younger group’s “insurance premiums” get folded into that scheme as well).
By Rok Spruk, on November 24th, 2009
A study by June O’Neill and Dave M. O’Neill (link) suggests that the U.S health care system provides more choice, efficiency, better delivery and capacity than the Canadian system:
“Does Canada’s publicly funded, single payer health care system deliver better health outcomes and distribute health resources more equitably than the multi-payer heavily private U.S. system? We show that the efficacy of health care systems cannot be usefully evaluated by comparisons of infant mortality and life expectancy. We analyze several alternative measures of health status using JCUSH (The Joint Canada/U.S. Survey of Health) and other surveys. We find a somewhat higher incidence of chronic health conditions in the U.S. than in Canada but somewhat greater U.S. access to treatment for these conditions. Moreover, a significantly higher percentage of U.S. women and men are screened for major forms of cancer. Although health status, measured in various ways is similar in both countries, mortality/incidence ratios for various cancers tend to be higher in Canada. The need to ration resources in Canada, where care is delivered “free”, ultimately leads to long waits. In the U.S., costs are more often a source of unmet needs. We also find that Canada has no more abolished the tendency for health status to improve with income than have other countries. Indeed, the health-income gradient is slightly steeper in Canada than it is in the U.S.”
By Russ Nelson, on November 17th, 2009
Folks, I have bad news for you. The Barack Obama Health Care Reform (shepherded through by Nancy Pelosi) will be, as written, an utter and unmitigated disaster. It attempts to do two things which are, in combination, impossible. First, it makes health insurance much more widely available through the mind-boggling deal it made with the insurance companies. To wit: the health insurance companies agree to insure everyone, and the federal government forces everyone to buy health insurance. While that’s a huge give-away to health insurance companies of your personal tax dollars, that’s not impossible.
No, the impossibility comes when you combine that with: Second, Barack is going to pay for this new plan by reducing costs. There’s two problems with this idea. A) if costs could be reduced, insurance companies would have already done it, and pocketed the money. B) when you pay less for something, you get less of it. This is one of the iron laws of economics, which is just as inviolable as the laws of thermodynamics, or the laws of mutual attraction (things fall at 32ft/sec/sec absent wind resistance).
So Obamacare will attempt to 1) increase the amount of medical care needed because you have all these newly insured people, AND 2) decrease the amount of medical care available by paying less for it.
No, really.
Stop laughing.
This is our PRESIDENT, and he deserves the same respect due to any other politician who is ignorant of economics yet tries to regulate markets: zero.
There can be only two results: either we’ll have less medical care (think you’re having a hard time finding a doctor now??), or we’ll pay a lot more for it (think your doctor’s visits are expensive now??).
But there is a different way: free market health care. Reduce every possible barrier to health care. First, stop protecting the doctor’s union. Let anybody practice medicine, but give the doctor’s union a super-trademark on the term “physician”, just like the 4-H shamrock and Olympic rings are protected. If you want a graduate of a medical school, you can have one; just go looking for a physician. Second, stop treating us like children, and let anybody buy any medicine they want. Abolish the FDA. Pharmacies will compete to provide the safest and most effective medicines. Abolish the patent system. Drugs are only expensive to develop because of the FDA and don’t need patent protection. Testing can be provided by pharmacies. Stop expecting doctors to be medical deities. Greatly reduce the available torts to only those things that doctors have control over, like leaving sponges inside patients after surgery. I’m sure there is more government hampering that I’m just not thinking of right now. Oh, yes, stop the war on (some) drugs. Abolish the ONDCP.
By Rok Spruk, on November 11th, 2009
David O. Meltzer and Zhuo Chen explored the relationship between minimum wage rate in the U.S and body weight (link):
“Growing consumption of increasingly less expensive food, and especially “fast food”, has been cited as a potential cause of increasing rate of obesity in the United States over the past several decades. Because the real minimum wage in the United States has declined by as much as half over 1968-2007 and because minimum wage labor is a major contributor to the cost of food away from home we hypothesized that changes in the minimum wage would be associated with changes in bodyweight over this period. To examine this, we use data from the Behavioral Risk Factor Surveillance System from 1984-2006 to test whether variation in the real minimum wage was associated with changes in body mass index (BMI). We also examine whether this association varied by gender, education and income, and used quantile regression to test whether the association varied over the BMI distribution. We also estimate the fraction of the increase in BMI since 1970 attributable to minimum wage declines. We find that a $1 decrease in the real minimum wage was associated with a 0.06 increase in BMI. This relationship was significant across gender and income groups and largest among the highest percentiles of the BMI distribution. Real minimum wage decreases can explain 10% of the change in BMI since 1970. We conclude that the declining real minimum wage rates has contributed to the increasing rate of overweight and obesity in the United States. Studies to clarify the mechanism by which minimum wages may affect obesity might help determine appropriate policy responses.”
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By Russ Nelson, on November 10th, 2009
The whole health care reform thing totally baffles me. Where do all these idiots (and yes, you ARE idiots) who support health care reform think the money is going to come from for all these improvements? Cost savings?? Sorry, idiots, but if savings were already available, insurance companies would have already gotten them, and kept them for themselves. Is that not completely obvious? Its GONNA cost more, and its GONNA cover less.
There is a way to get more for less, but it requires that people understand and accept that free markets actually work. And yet there are so many people who are convinced that somehoww health care is some kind of magic market where the laws of economics don’t fly, where pigs do fly, and where everyone can get all the health care they want for almost
no money.
And a pony.
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