Comments on: Healthcare Economist Manifesto

By: Healthcare Economist · Rationing Health Care

Healthcare Economist · Rationing Health Care — Mon, 20 Jul 2009 07:23:20 +0000

[...] I’ve said many times before, health care is a scarce good an must be rationed. Unlike most goods, healthy [...]

By: David Smith

David Smith — Wed, 08 Jul 2009 19:02:50 +0000

Thanks for writing this pretty level-headed article. I think it’s best to keep all these options always open to everyone. There has to be some competition in all these areas. Closing off avenues in the area of healthcare is just a bad idea and we should look to other countries before diving in to a Universal system. France has a sort of hybrid between the USA and Europe’s socialized medicine and it seems to be working “okay.” But every government that tries it can easily bankrupt themselves, because we all will die, and we’ll all have a lot of expenses in those last few days. Let’s be careful. Yoda said, “Once you start down the dark path, forever will it dominate your destiny.” This could be a dark path, and there’s no turning back. Once people start getting something for “free”….

By: Steve White, M.D.

Steve White, M.D. — Mon, 29 Jun 2009 21:43:35 +0000

You make this comment:

Doctors are expensive. Why? For three reasons: 1) they provide high value services, 2) going to medical school is costly, 3) they participate in a cartel known as the AMA.

The AMA is not a cartel. It exercises no cartel powers. A cartel “is a formal (explicit) agreement among firms. It is a formal organization of producers that agree to coordinate prices and production.” (Wiki). The AMA has no formal agreement amongst doctors to provide service at set fees, nor are its members coordinating fees and services provided. OPEC may be a cartel, but the AMA is not.

Further, fewer than 40% of licensed physicians are members of the AMA, and the proportion of physicians who belong has been declining. Because of that, the AMA could not exert cartel power even if so inclined.

I am a physician but do not and have never belonged to the AMA.

By: marta

marta — Sun, 28 Jun 2009 15:59:07 +0000

Lots of good information processed here. I think the private health insurance companies in the European system are not allowed to make a profit unlike in the U.S. That is why it works over there.

By: Jason Shafrin

Jason Shafrin — Thu, 25 Jun 2009 17:58:05 +0000

I agree that programs to reduce smoking, drinking and obesity are very important. This can help individuals significantly improve their quality of life as well as improve longevity. However, people who claim that we can significantly reduce health care costs just by reducing smoking, drinking and obesity are incorrect. It is possible that instituting counseling for smoking, drinking and obesity can increase cost as people live longer. I am not saying that this will not be money well spent, only that it will not significantly reduce medical costs in the U.S.

By: Ben

Ben — Thu, 25 Jun 2009 16:37:21 +0000

Reducing cost for programs for smoking, drinking, and obesity? There is some fairly strong evidence that such programs are effective and further working studies on the way that support this.

As a just finished Ph.D. student you should know that mechanisms to help people with self-control problems can sometimes be useful!

I love the post in general, it provides some good insight into what people should be focusing on.

–Ben

By: Healthcare Economist · Health Wonk Review: Confederations Cup Edition

Healthcare Economist · Health Wonk Review: Confederations Cup Edition — Thu, 25 Jun 2009 07:06:18 +0000

[...] What be included in any health reform proposals? The Healthcare Economist weighs in with his Healthcare Economist Manifesto. [...]

By: Matthew Holt

Matthew Holt — Wed, 24 Jun 2009 02:27:03 +0000

Jason

In general Holland is the best model for the US. We wont get there of course….and user fees are a zombie (see Bob Evans)

One minor remark. You think you opt out of the NHS in the UK? You can purchase private health insurance and even use it for certain things (usually elective surgery). But almost every Brit has a local GP (paid by the state) and no Brit can opt out of paying for the NHS, unless they want to go to jail….it’s called the Inland Revenue Service, and they will come to your house and take you to jail if you decide to opt-out of paying

Matthew

By: Akshay Kapur

Akshay Kapur — Mon, 22 Jun 2009 11:29:41 +0000

Jason,

I have already emailed, twittered, bookmarked and in any other possible way shared this with the majority of people I know. The effort you put into this is obvious and yet it flows as a single thought process really well.

From rationing to supply-induced demand to patent policy, you’ve covered an a LOT of ground.

The best part is how open-ended you leave it. There is no single solution but a lot of interrelated options for pursuing reform. We can learn from other systems and utilize the current political environment to hopefully make those small key changes that won’t hurt the SIGs too much, but will help everyone as potential future patients.

This made me laugh out loud: “they participate in a cartel known as the AMA.” Totally caught me off guard.

Congratulations on graduating and I hope you achieve a lot of what’s written here. Looking forward to more great stuff.

-Akshay