Jonathan Cohn has this to say about universal health coverage:
Of course, the idea of involving the government in these decisions is anathema to many conservatives–since, they argue, the private sector is bound to make better decisions than a bunch of bureaucrats in Washington. But, while that’s frequently true in economics, health care may be an exception. One feature of the U.S. insurance system is its relentless focus on short-term good. Private insurers have little incentive to pay for interventions that don’t yield immediate benefits, because they are gaining and losing members all the time. As a result, money invested on patient health may very well help a competitor’s bottom line. What’s more, the for-profit insurance industry–like the pharmaceutical and device industries–responds to Wall Street, which cares more about quarterly filings than long-term financial health. So there’s relatively little incentive to spend money on the kinds of innovations that yield long-term, diffuse benefits–such as the creation of a better information infrastructure that would help both doctors and consumers judge what treatments are necessary when.
Health care may be one of thise areas that the market is not the best judge of what should be produced and how much of it should be consumed. I would add that to an extent health care is also a “blind item” in that you are depending on an expert in the form of a doctor to tell you what is the best course of treatment. Most of us do not possess the expertise to diagnose are own illnesses and certainly cannot treat most of them ourselves. For this we depend on an expert and if that expert is guided by a profit motive the advice may not always be the best.
The entire article is here and well worth reading
Big pharma is surely guilty of over marketing/hyping, as well as bribery of doctors.
But who else has come up with anywhere near the medical innovation? And please don’t tell me the government nor feng-shui acupuncturists …
Comapring and contrasting fairy godmothers and government:
Pragmatic Health
Another great look, this one from the NY Times:
http://www.nytimes.com/2007/11/30/business/30golden.html?_r=1&oref=slogin
CB:
Health care needs reform on almost every front, both on the supply side of things, like oxegen bottles and on the financial side.
The system we have now creates a situation where the government takes on the most expensive clients, by giving everyone over a certain age medicare, leaving all the more profitable clients for private companies. While at the same time Drug companies and doctors spend millions to market needless services to people knowing that the government will pay for it. As Alan Simpson points out in the article, it is carreer suicide to deny anything to seniors and the insurance companies and seniors know this so they keep getting them to want more stuff, even when it does not help their health.
The system does need a complete overhaul, I hope universal health coverage is a step towards that overhaul.
John: I’m glad that we agree that drug companies, doctors (and hospitals and insuarance companies) knowingly project the government dole. Universal health care does not change the equation. There will be a lot of money dedicated to healthcare, lobbyists will work on the officials who decide who gets what, and we will see more of the same (without any accountability in the freer markets).
It will be like Social Security–people are forced to do it, instead of choosing to opt in or out. Being forced to do something with the threat of jail is not quite as bad as with guns pointed, but you know, it is not promoting individual choice nor freedom.
CB:
It is probably not politically feasible to make health care perfect, for many reasons, not the least of which is that lobbyist will make sure their clients get their moneys worth of any health care program, but I don’t think that means that we should give up on trying to at least create a system that offers unversal access.
Healthcare is unique in that most people do not have enough information to make the best decisions for themselves, unless you are an MD their are things that you are not going to understand about your own health, so you are forced to rely on a doctors advice. In many cases that advice is tainted by which company is paying your doctor to promote a certain drug or procedure. The market rewards the doctors who are best at selling products not the doctors who are best at keeping people healthy. In fact most doctors have an incentive to keep people somewhat unhealthy so that they will need to continue seeking treatment, who is a better patient than an obese indavidual with diabetes and arthritis. This person will live for a long time and need numerous treatments and drugs for most of that life, the best thing the doctor can do is encourage this person to stay unhealthy, at least from a financial perspective that is the best thing the doctor can do. That is why the market may not be the best way to fix the current medical problems.