Sunday, August 06, 2006

Has American health care really failed?

Dana hanley sent a message earlier to the Life, Liberty, Property community's e-mail list:
Question...do any of you have some nice posts on medical care? Something with a bit of research...and particularly anything about the cost of health care (ie., the real costs of socialized medicine as opposed to our system?) I don't know that much about it, but cannot imagine that the government runs it more cheaply. And I know what it is like to be treated in a socialized system such as Germany's or England's...(I sat bleeding profusely in a London ER listening to a 12 yo girl scream for hours. Finally I was told I was miscarrying and to go home. They couldn't do anything until Monday at the earliest (it was Friday night). I was advised to return to Germany because my doctor there would see me sooner.)

Our health care system apparently is evidence of the failure of our American way of doing things. I'm still trying to sort out how air proves that socialism is superior to individual rights/liberties. But that is a separate story.
My reply:

A few thoughts, dana. Lots of groups have done studies, from Cato and the Heritage Foundation to all the big left-wing (socialist) groups. However, all these groups have their own axes to grind, and there are difficulties anyway with doing precise, empirical analysis of entire health care systems.

Government intervention creates incentives but necessarily destroys others (typically to a greater magnitude than anything it creates). The effects can be widely dispersed and impossible to account for completely, so it's hard to calculate "real" costs as you would like. Think of it this hypothetical scenario: if there's an increase (relative to population increase) in consumer demand for oranges, how much could be attributed to a new tariff on imported bananas? How much came from a marketing blitz by orchard growers and Florida's state government? And that's an easy one. The Canadian and European models have high disincentives for health care providers, with high incentives for people to consume health care resources. The U.S. system has high incentives for some (i.e. subsidized) people to consume health care resources, which also price insurance beyond what others can afford (I believe Cato estimated that regulations make health insurance too expensive for 7 million americans), with a lot of regulations that both encourage and hinder providers.

The issue is more "how to allocate health care resources" than "how to provide health care resources." We already are producing an amazing amount of health care, just not in sufficient quantity to satisfy what everyone would like. So if there is a "problem" with American health care, I see it as no different than any other resource that's too limited and in relatively high demand.

Some proponents of socialized medicine claim the problem is that Americans pay more but get less, but is that really so? Here's where we can make the only real comparison, albeit a subjective one: where would you rather live? I will concede the failure of the American health care system (whatever the hell "health care system" means when ours is still private enough to involve an uncalculably vast web of individual transactions), and unequivocably support socialized medicine, once the following happen:

1. Fifteen thousand Americans, mostly elderly, die during a heat wave, in no small part because it's a traditional vacation month (as effected by law), leaving nursing homes and hospitals understaffed with doctors. Oh, should I add that air conditioning is rare in French nursing homes, because of crazy health laws? It's not the need in a mostly temperate climate, nor the expense.

2. Americans start traveling to Canada en masse for operations, because they might die while waiting many months in the United States.

3. Waiting times for elective surgery surgery in the U.S. degenerate to what they are in Europe.
http://cafehayek.typepad.com/hayek/2006/02/waiting_here_an.html

4. Cancer survival rates in the U.S. degenerate to what they are in Europe.
http://cafehayek.typepad.com/hayek/2006/02/youve_had_your_.html

Much could be improved with U.S. health care, namely that all governments should get out of the business. Yet I'll still unhesitatingly take our present system over socialized health care.

Under socialized medicine, you were told to just go home, or even leave the country! On the other hand, one of my friends received help at a hospital other than where she'll have her baby. With a few weeks left, she started dilating, and then there was a little bleeding. Her parents rushed her to the emergency room at the nearest hospital, where a doctor was able to see her. It turned out to be nothing serious, thank God, probably that this is her first pregnancy and her cervix is tender. The doctor didn't have ready access to her medical history, which was not a problem since my friend could supply relevant details. Similarly, my friend could supply her insurance information, so the doctor was able to bill her insurance company with no problem.

In a way, Americans do pay more for less -- less of an undesirable thing. I willingly pay money to get less of, for example, stains on my clothes, much like I'll visit a doctor to get a prescription for an antibiotic which will leave fewer germs in my body.

(Side note: some might nitpick my poor grammar in the last paragraph, but I used "less of" referring to stains so I could use the same phrasing as the previous sentence.)

4 Comments:

Anonymous Anonymous said...

Not to mention the recent news story from England, about the hospitak that was severely fined by the NHS because it was treating patients too fast!
Seems the goal is 122 waiting days to see a specialist (consultant?) and this hospital was letting patients see one almost immediately.

Tuesday, August 08, 2006 9:35:00 AM  
Anonymous Quincy said...

While this is not at all empirical, I will make the simple point that the American system of rationing through price is infinitely more humane than rationing through waiting time.

About 7 years ago, I had a very severe knee injury that almost robbed me of the ability to walk. Had I been forced to wait 122 days, heck even two or three weeks, to see a specialist about this injury, I would surely be in a wheelchair at this point. The ER doctor realized that, while the injury was not life threatening, a specialist should have contacted immediately. The specialist was, and the knee reconstruction took place less than a week later.

It's this kind of response that only a market-based system can provide, and considering how much pain I was in in that week, I find it truly horrendous that anyone can think that a waiting list is an appropriate way to allocate medical care. I would not have wished what I was feeling on anyone.

Wednesday, August 09, 2006 2:10:00 AM  
Anonymous Andy Davidson said...

You wrote: Fifteen thousand Americans, mostly elderly, die during a heat wave... Didn't you mean French?

Friday, August 11, 2006 3:49:00 PM  
Blogger Perry Eidelbus said...

Ah. I said that I'll support socialized medicine once 15,000 Americans die during a heat wave, referring to the French.

Saturday, August 12, 2006 1:06:00 PM  

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