My Comments on Michaels Blog w/r/to National Healthcare

Yeah - I feel like tossing in my two cents on several points of your discussion.

1. By and large consumers are ignorant and take actions inconsistent with their long-term well-being. This is the unique by-product of the market economy and human nature. We all know that we need to save for retirement, health emergencies, etc….credit cards are bad, live below your means and all that jazz…..but not that many people actually do these things. Which is why gov’t’s provide ‘an out’ or a safety net such that we as a civilized people realize that certain bad decisions should never lead to someone being hungry or homeless or left to die of a debilitating disease w/o comfort and treatment. I think most people are comfortable with the proposition that if you’re an idiot and don’t plan for retirement, you shouldn’t complain when you can’t buy a condo in Del Boca Vista. I think most people are uncomfortable with the proposition that if you’re an idiot and don’t plan for retirement, you shouldn’t complain when you’re forced to live in a box during your final years.

The same holds true for Healthcare - people make bad decisions, and the honest reality is that ‘the people’, as in all of them, will never be educated sufficiently OR take interest sufficiently to plan for their own health emergencies. And I can’t imagine anyone with a soul saying “Hey - sorry - you weren’t responsible enough for your own health care, so go ahead and die your painful and preventable death.

But hey - the devil you know is better than the devil you don’t know. So, since we know how people are and what the consequences will be (and are) we can plan accordingly - and the best plan is a nationalized health care system.

2. The American Healthcare System - is a stunning example of market failure. Even the most ardent Chicago schoolers will admit that in our practical reality, market failure can and does exist. Just take a look at the incentive structures w/i the Healthcare industry in the abstract and then look to our practical experience - it’s really quite clear. Above, Michael noted that simple fact that our for-profit healthcare industry has some ‘interesting’ incentives w/r/to keeping people health and paying for their treatment. Let’s just take that and look at our current system, the adminstrative overhead of our private, market insurance industry are about 30% - why? Because insurance companies spend a lot of money paying people to try to avoid paying claims. How can anyone claim this is efficient? And if it’s not efficient, why in a country religiously dedicated to economic efficiency do we continue down this path…..something tells me to follow the money….

3. There is absolutely no question that our market-based healthcare system is the most expensive in the world…..and what are buying ourselves - mediocre health standards compared to the rest of the western world. So as to the “Lets disagree about how best to provide healthcare” - there is really no disagreement outside of an ideological straightjacket. The data is unequivocal - national healthcare systems are cheaper and better - at least amongst comparable western nations.

4. Also, one last thing - this is of particular interest to me, but not really relevant to your post/discussion. And I have only anecdotal evidence to support my thoughts - though they are logical. I wonder about the motivations of the people we (America) attract as caregivers to our healthcare system. It seems to me that other countries (France) have it better. I say this b/c we pay doctors exorbitant salaries, in order to pay for their exorbitant student loans and their exorbitant medical malpractice insurance. Whereas the French don’t - med school is free to those who are smart enough and have the desire to practice medicine. I think that our system focuses so much on money that we may sacrifice individuals (or place them out of the ‘market’) who are truly devoted to patient care - but they don’t want to go through the bullshit of practicing medicine in the U.S. Yeah - again - this is just something that I think about from time to time - and it makes me wonder if we should take another look at the whole system.

Sadly, it is unlikely that we will have significant movement in the U.S. toward national healthcare, simply because of the power of the insurance companies here (BTW, guess who made out when Texas enacted Tort Reform….I’ll give you a clue - it wasn’t the consumer). But this is a curious situation, where the market system - stalwart of efficiency - is second best in sum and substance to a state-run bureaucracy…..though I guess anyone who would classify Public Health as a Public Good wouldn’t be surprised.