In response to my last post. Gee, someone actually visited here. Maybe somebody flagged me for “fishy” or whatever. When guys in dark suits visit, then I’ll worry.
So, this was the (yeah, as in singular) comment.
So…are you suggesting that rationing care based on wealth (the system we have now) would be better than need (the system being debated)?
And to imply that the current system is based on an individual’s best interest is folly, unless that individual is the CEO of a private insurance conglomerate.
Furthermore, your example of an organ transplant indicates that you know very little of current organ policy or the mechanisms through which that is changed.
I have written many times here about the problems with health care. Rather than go back and requote myself, I’ll leave it as an exercise to the reader’s curiosity (as well as add to my visit counts!!).
Let’s look at each each part:
Ration based on wealth rather than need.
First, everything is rationed, period. That’s the result of things being scarce. Econ 101. We don’t ration on “wealth” but on price. There’s a huge difference.
Now, the cost of medical care will be more for me than someone of much greater means, even if the price is the same. This means simply that if I spend $1000 on health care, and my income is $50,000, it constitutes a bigger share of my income than my income was $100,000. Thus, I would be giving up more, and must ration my other purchases more.
The problem with rationing on need, is we haven’t any idea how to determine “need”. It is an arbitrary and capricious standard, one for which no objective or measurable unit exists, nor could exist. With a purely price based system, we can then truly know (in fact it’s the only way to know) individual preferences. Mises wrote about this in Human Action. I quoted the relevant selection a few posts back. Take a look.
Now, say one can’t afford to purchase the particular service but another can. By what power hath the state authority to prevent one from purchasing something they can afford, yet force the very same person to purchase it for another?
And, we in fact do ration, well pretty much everything, according to price. It is why I haven’t a Porsche. Or an Accurate fishing reel. Though I can’t in any sense afford a Porsche, I actually could an Accurate fishing reel. However, there are other, higher priority items that I purchase in lieu of the fishing reel.
Of the X million “uninsured”, are many who simply choose not to be insured. But please keep in mind, that despite being “uninsured”, many millions of people are treated. The “cost” is shifted to those with insurance by higher premiums, deductibles, and co-pays, not to mention higher prices for all the various and sundry medical purchases.
Also, as the government currently spends 46 cents out of every health care dollar, they do dominate the market. And, through medi -care, -caid, -cal, et al., it pays vastly under the market price. In fact, many doctors refuse to take medi-whatever anymore.
Insurance CEO’s best interest
Of course, demagoguery, the favorite pastime of the left!!
Insurance is actually the problem in as much as someone other than the consumer is paying. And insurance is the problem in as much as the consumer and producer are both dealing with a third party whose “cost” is entirely different than the doctor’s or patient’s.
Insurance by its definition is something you don’t plan to use, such as auto insurance. It is simply there “just in case”. But, when you DO plan on using “insurance”, it isn’t. What we have created is a terrible market distortion, whereby many people pay into a “pool” (I already posted why pooling is theft. ought to check it out too.) and some gain while some lose. In no other good or service do we do such foolish and diseconomic actions.
Of course the CEO of an insurance company must act in his best interest, he has absolute incentive to: he’s paying. Were the consumer paying the producer’s price, then the entire situation would be different. Why do we expect someone else to pay for our health care, then get furious when they balk at times?
The problem is that we don’t ration, or think we have to, health care the same as any other item. If we were to have insurance, instead of a purely pay-for-service, like, um, everything else, then it ought to be entirely one of insurance company selling to the individual. Why do we believe our employers are more qualified to provide for our health care needs than we are?
No, I’m not familiar with the entire process. I understand that it is not based on price rationing, but a waiting list. (I do remember several years ago when Mickey Mantle got a liver transplant, all the ruckus it created.) Ironically, waiting lists are entirely a form of rationing. It does save someone (directly that is) from basically sentencing someone to death, but no matter.
But, the specifics of organ transplants, or any surgery, or any procedure for that matter, are irrelevant. The simple fact is that as the single payer (I know, the administration isn’t proposing single payer. And the earth is flat. Public option will become single payer. It’s already been demonstrated, that’s the backdoor plan. Sure, you can “keep your current plan”, but not if your employer no longer offers it. See above.), what is known in microeconomics as a monopsony, they will decide entirely what they will and won’t pay for.
And before they decide to spend the money, they will most certainly have to make the cost/benefit analysis that all decision makers must.
Interestingly enough, they have waiting lists for all sorts of procedures in Canada, UK, et al. There’s no other way. So, someone has to be making the decision, and yes, there are many factors. However, the administration, ah hell, dear leader himself, has already said we need to consider just how necessary every procedure is on granny. And yes, he did, his circumlocutions not achieving their intended effect.
The bottom line is we have anything BUT a free market in health care. Period. And that is exactly the problem.
But thanks for taking the time to visit and comment. Much appreciated.