A collapse of confidence
I've been diligently avoiding making posts lately about politics, economics or business. Perhaps the biggest reason for this is that, lately, I feel like I know almost zero about any of them. Anything predictable by my particular brand of common sense has gone straight out the window, and for the first time in at least the last decade, I feel
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I always find it interesting when hard-core marketeers defend our health care system. By any rational standard, it has been found wanting. We spend more of our GDP than any other industrialized nation, and yet our health statistics are mostly way below theirs. So we pay more to get less. Isn't the free market supposed to deliver the opposite result?
Only it can't, for the very reason you yourself state: health care is not a commodity. If it were, then the market would (eventually) give us the best product at the best price. But non-commodities are the one thing that markets tend to really suck at evaluating. So why should we trust the Free Market Fairy to handle it?
Put another way, the most expensive estimate I've heard for Universal Health Care is $2 trillion a year. Interestingly, the health care industry is a $2 trillion-per-year segment of the economy. So we can, indeed, afford it as a nation. We just choose not to, and for reasons that never quite make sense to me.
Oh, and I'm going to head off a few of the usual bugaboos here. Not all socialized health systems have longer wait times than the U.S. (Germany, for one, has much shorter). There are individual horror stories to be found in any system of health care, and the systems in other industrialized countries do not have a monopoly on them. Health care is rationed no matter what system you use; the question is what you choose to ration. Another way to put that is that any system involves a tradeoff between efficiency and equity, and how we balance those determines what gets rationed. Malpractice insurance costs are a problem, but so is the Frankensteinian billing structure. (And hey, I bet you any UHC system will include massive tort reform as a way to defend the system, so what's the problem?)
Sorry, but we can do better. What form that takes is up for grabs, but the basic evidence shows that we're underperforming and paying too much to do it. Maybe the Cleveland Clinic has the right model.
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You may believe Paul Krugman all you want. And I am in full agreement with him on some issues-- including a firm belief that UHC will be too costly without major cost cutting measures. Yet, I have not seen much discussion on how costs will be cut. Besides magic, of course.
I also must add that the "Free Market Fairy" hasn't paid a visit to the U.S. healthcare system in many, many years.
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