John Cochrane, a well known financial economist and former president of the American Finance Association, last month wrote a blog post [0] reacting to a similar article in Bloomberg about the pricing of air ambulance services. If you want to see how bizarre the structure of our markets for healthcare services looks to an economist, I encourage you to read it.
I wonder if there’s a collection of this sort of article somewhere, all these journalistic accounts of ordinary people’s financially nightmarish encounters with the American market for healthcare. It feels like I’ve read dozens of them, and they’re all basically similar, not just in the facts they relate of each debacle, but also in their lack of insight into what’s really so fundamentally broken about our healthcare markets.
That's a superb article, and it makes some extremely valuable points.
It wouldn't be that hard to just take a bunch of tax money, and provide a bunch of health care. Or alternatively, provide a bunch of health insurance. But since the US isn't willing to do that, but does want the services, we get this.
There's no free lunch, and the harder you try and find one, the more warped (and, ultimately, expensive) it's going to end up being.
> "It wouldn't be that hard to just take a bunch of tax money, and provide a bunch of health care. Or alternatively, provide a bunch of health insurance."
I don't even get if you're trying to make a point. I'm french and for all my life a doctor appointment has never been higher than 1 euro. All important operations are covered and i could not even tell you one that's not exept plastic surgery (and maybe lasik "in some cases").
I'm not even sure the txation in france is higher than in the US.
Not sure if you're being sarcastic or not. If you want to raise a lot of money, you really want a VAT or GST, probably in the 15-20% level. These are excellent at raising revenue because they hit everyone, rich and poor alike, and they're extremely difficult to dodge.
Then you spend this money on health care (ideally), or (failing that) health insurance (the point of insurance is the spread risk, but the government is already a big enough risk pool, so anything other than self-insuring is a blatant waste of money), with a strong focus on just letting the market work. Do you wish that everyone had access to treatment A? Then just pay people to provide it. It's amazing how well that works!
(One of the ironies of this debate is that the US tends to be shockingly socialist in how it provisions care. Land of the free, home of the brave, right up until it involves medicine, and then it's the last redoubt of five year plans, price setting, and socialist planning, which works just as well as it did under Khrushchev. Northern European countries have eye watering taxes, but the saving grace is that they spend the money efficiently.)
This is the sort of thing that basically all other first world countries have done, and it works pretty well. It's not cheap (anywhere), and it would be especially not cheap in the US due to their very, very long history of making poor choices that drive up the cost of health care, but it's a viable option.
(Example: Most first world countries build hospitals in order to provide a lot of high quality care efficiently. This means things like large open wards, because that allows a smaller number of nurses to monitor a larger number of patients, and nurses are expensive, and it's not like having a private room is going to make your broken leg heal faster. In the US, hospitals are build without open wards, because patents prefer private rooms, and who cares if that makes things horrifically expensive, because the guiding principle of US health care is "I don't care what it costs, I'm not the one picking up the tab!". Unfortunately, those hospitals have been built, and they're not readily retrofitable to more sensible designs, and we'll be paying off the bonds used to finance them for decades. Which means everything in the US will be needlessly expensive regardless of how you pay for it, but it's too late to fix it now.)
Of course, politically, none of this is going to happen; instead Congress will just keep passing laws to mandate More Good Stuff and Less Bad Stuff, and then feeling very aggrieved when it doesn't work out. The history of US health care since WWII has basically been one long string of poorly thought out reforms that have driven prices up. Why stop now? But just because the US won't do it doesn't mean it wouldn't be easy if they wanted to.
I wonder if there’s a collection of this sort of article somewhere, all these journalistic accounts of ordinary people’s financially nightmarish encounters with the American market for healthcare. It feels like I’ve read dozens of them, and they’re all basically similar, not just in the facts they relate of each debacle, but also in their lack of insight into what’s really so fundamentally broken about our healthcare markets.
0. https://johnhcochrane.blogspot.com/2018/06/cross-subsidies.h...