tag:blogger.com,1999:blog-582368152716771238.post1168633677736529770..comments2024-03-28T14:41:03.793-05:00Comments on The Grumpy Economist: After the ACA: Freeing the market for health careJohn H. Cochranehttp://www.blogger.com/profile/04842601651429471525noreply@blogger.comBlogger40125tag:blogger.com,1999:blog-582368152716771238.post-57541526198704946362017-09-27T01:02:16.199-05:002017-09-27T01:02:16.199-05:00Your Post is very useful, I am truly to this blog ...Your Post is very useful, I am truly to this blog which is specially design about the exceptiona healthcare It helped me with ocean of awareness so I really appreciate your blog.<br /><a href="http://ehc-er.com/" rel="nofollow">exceptiona healthcare Brownsville ER</a>Andrew Carterhttps://www.blogger.com/profile/09977756330792658096noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-63081447972618379812016-01-26T16:28:25.595-06:002016-01-26T16:28:25.595-06:00I suppose it must be a separate article, but I see...I suppose it must be a separate article, but I see no possible way to implement a system implied by these ideas, practically or politically. And that's too bad. If such a proposal could be devised, we could at least start talking about it. I hate, too, that hatred and demonization in the political sphere have poisoned the very air in which any real discussion could take place. <br /><br />A few of my words of praise for the ACA have been that at least motion has been restored to the ocean in health care and I looked for future improvements. The author has depressed me by showing why entrenched interests are even further dug in. Unfortunately, I feel we will have to clean up our Congress before real reform can occur in health care.Anonymoushttps://www.blogger.com/profile/17861370127605278422noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-91500063642254039752015-02-28T00:31:45.286-06:002015-02-28T00:31:45.286-06:00CLICK HERE FOR WHAT HAPPENS WHEN YOU GOOGLE OR BIN...<a href="http://gastricbypasskills.blogspot.com/2015/02/doctors-are.html" rel="nofollow">CLICK HERE FOR WHAT HAPPENS WHEN YOU GOOGLE OR BING "DOCTORS ARE"</a><br /><br />I addition to most doctors being asshole the are the biggest thieves and killers in America and the world.Fat Bastardohttps://www.blogger.com/profile/03839915109115122588noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-54360570027488286702013-10-20T15:06:27.024-05:002013-10-20T15:06:27.024-05:00Excellent article. Excellent article. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-42777066124631955322013-01-08T00:38:28.790-06:002013-01-08T00:38:28.790-06:00There's an alternative: Subsidize hospitals th...There's an alternative: Subsidize hospitals that provide charity care.<br /><br />Already, Medicaid is essentially a subsidy for charity care (it compensates for only 80-90% of overall treatment costs). But Medicaid is complex and expensive to administer, and it uses fee-for-service price controls which distort physicians' treatment incentives (since they're rewarded for providing treatments that are reimbursed at higher rates).<br /><br />Better than Medicaid, I think, would be for the government or a charitable organization to write the hospital a check for X% of its charity care or uncompensated treatment expenses. That way, the hospital could keep control of treatment decisions even as the third party helps to pay the cost of that treatment.Jeremy Kohnhttp://www.linkedin.com/in/jeremykohnnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-70038880649060935102012-12-20T04:17:50.893-06:002012-12-20T04:17:50.893-06:00Excellent piece. Really enjoyed it. Thanks for sha...Excellent piece. Really enjoyed it. Thanks for sharingkhairul044http://dwaynepyle.com/shop-earn-review-truthnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-59579206908910079662012-12-12T06:22:21.421-06:002012-12-12T06:22:21.421-06:00This will be offered by govt and by personal chari...This will be offered by govt and by personal charitable organisation." Thus, either govt or personal charitable organisation is to figure out who gets help, what excellent, and how much. In other terms, some categories should actually come in contact with control by govt and charitable organisation.<br />Compra Oro Platahttp://comprooroyplatabarcelona.es/noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-55802641479107431912012-11-30T00:11:04.619-06:002012-11-30T00:11:04.619-06:00Agree :)Agree :)Anonymoushttps://www.blogger.com/profile/13351082682233636516noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-22944772248089139782012-11-19T19:32:43.527-06:002012-11-19T19:32:43.527-06:00I would appreciate comment on the possible contrad...I would appreciate comment on the possible contradiction:<br /><br />On one hand regulation is the enemy because it "(...) does a poor job on the dimensions we care about. Regulators can impose minimum standards, requiring degrees, certification, inspections, etc. and keep out really dangerous quacks. But beyond that they are terrible at pushing for higher quality, especially when quality is so much in the experience of a customer in a service-oriented business." Thus, we should avoid resorting to the institutions which provide regulation on health care such as government (openly stated regulation provided by laws) or charity (internal regulations provided by charity policy). The criticism is that they arbitrarily determine who gets care, what quality of care, and how much.<br /><br />But on the other hand "we will also need charity care for those who fall through the cracks, the victims of awful disasters, the very poor, and the mentally ill. This will be provided by government and by private charity." Thus, either government or private charity is to determine who gets help, what quality, and how much. In other words, some groups should actually be exposed to regulation by government and charity.<br /><br />So my question is, why institutions which are the enemy of the system are at the same time the saviors for the most vulnerable? Why poor are to be treated differently than vast majority of Americans and cannot experience the benefits of the free market in health care?emilyhttps://www.blogger.com/profile/02416210480605500925noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-20586009844784192422012-11-14T15:55:39.838-06:002012-11-14T15:55:39.838-06:00I would add that more than healthcare needs reform...I would add that more than healthcare needs reformed. Our food supply, and for some lack of access, is part of the problem when it comes to handling our health. Our cities are designed unfriendly to pedestrians and bikes. In Europe, they get plenty of exercise as part of their every days life by walking and biking to work. They don't have to carve out extra time to go to the gym. But we are built with suburb housing in one location, work and shops in another.<br /><br />In order to healthcare prices to come down, we as a population need to have access to a culture that is more supportive of a healthy lifestyle.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-26961301582042755912012-11-09T17:22:38.787-06:002012-11-09T17:22:38.787-06:00Well, the election is over, and the American Peopl...Well, the election is over, and the American People have decided they want to adopt the Greek system of political economy.<br /><br />I guess this will turn out like the public schools. Anybody with money will hire a concierge physician and go to a private hospital in the Caribbean, if he needs hospitalization. The proles will be in P.S 187, getting medical care that is just as good as the education the kids in public school get, which is to say almost worthless. Medical innovation? forget about it. Some will occur in the private system and will leak into the public system if it really saves money. <br /><br />The only virtue I see in this system is that it will accelerate the day that the Peoples Democrat Republic of what used to be the United States of America will collapse in utter bankruptcy.Fat Manhttps://www.blogger.com/profile/09554029467445000453noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-642648937747841212012-11-09T03:57:03.887-06:002012-11-09T03:57:03.887-06:00Great essay.
I'm a US expat living in Germany...Great essay.<br /><br />I'm a US expat living in Germany, and have physicians, working both in private practice and for a government-owned and run hospital, as friends, there are two major differences in US and Europe.<br /><br />Physician income and tort law.<br /><br />The physician friend who works at the hospital (in a stroke unit) works a 35-hour week, variable day length (i.e. she can be at work for 2 full days and then work just one day the rest of the week, depending on scheduling) and earns around €50k/year. She has a very nice benefits package and is pleased with her life-long employment promise and relaxed life style.<br /><br />The other, who is my physician, has around 700 private patients and works a 70-hour week, an internist specializing in diabetes (which I do not have). He takes in around €300k/year, which after praxis costs nets him around €160k/year.<br /><br />In both cases, their liability insurance is only around €2k/year: they have never been sued.<br /><br />Now, my kid brother is a diagnostic specialist in a doctor-owned clinic: his liability insurance is slightly larger than his annual income, but since the clinic pays for it, he doesn't notice it. But that price is reflected in fees. He also has never been sued.<br /><br />As long as you have tort lawyers able to have jury trials for medical errors and acts of both commission and omission that lead to multiple millions of dollars in payouts, you will not be able to reduce costs meaningfully in the health system. Period.<br /><br />Oh, and yes: it does mean that doctors who make errors don't pay much for these errors. German courts are loath to grant more than a few thousand in pain and suffering cases, and they're capped at around €50k in any case.<br /><br />It's a fundamental trade-off: lower costs in exchange for losing the ability to sue and make millions off a court case. Gonna have to fight the lawyers on that one!John F. Opiehttps://www.blogger.com/profile/00445399643146235960noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-37272904283644558802012-11-05T10:44:58.839-06:002012-11-05T10:44:58.839-06:00"My views are evolving." But if I feel r..."My views are evolving." But if I feel right that you think most of these problems belong to IO and political economy, not finance (or PF), I see your point. Thanks for this.<br /><br />That said, I think it's borderline-facetious to pretend that political economy problems can be solved by simple deregulation. I guess it did not go well for the financial industry. Yes, it worked better for retail, airlines or telecommunications, but we need to be more careful about what made the good examples work.<br /><br />Finally, I am not sure the insurance problems are that separable from the health care problems (IO and political econ). Let me try to argue why. I think our body politic, our nation, our community cannot bear the thought of people really getting no care — even if you could argue that they "chose" not to when they did not allocate their budgets accordingly. And I think most conservatives share this feeling. Maybe some philosophical training and some public campaigns could help matters, but I wonder how much. Sure, we only want to pay for "necessary" treatments and not elective MRIs, but to make those choices, regulated efficiency creeps back in. Actually, creeps back big time. But the alternative of trying to draw a line in the sand is not credible. Medicare Part D was an overt, irresponsible and potentially consciously dishonest mistake of conservatives. But well-meaning (Ryancare) vouchers might be more grievous a mistake, even if unconscious and honest. When the elderly start going bankrupt because of bad financial planning, Republicans would bail them out just as much (unless they cynically wait only as long as a Democratic administration picks up the bill before them). The kindergarten-worthy solution of limiting spending by simply promising not to spend more does not stand economic scrutiny. (Also, if actual health care spending, even private, is partly controversial and worrying, e.g. because of IO problems, then it is not much better to let it happen because of private demand without further public financing.)<br /><br />But if denying treatment is unacceptable, we are back to the insurance problems, public insurance that is, with all the IO and political econ, let it be "simply" regulation or public financing, horrible dicta, public provision.<br /><br />This is also a bit relevant while the public sector has a hard time letting the education sector go (or figure out how to let it go exactly). Arguably, education is somewhere between retail and health care on this spectrum. <br /><br />By the way, I wonder if you really meant Akerlof-unravelling and not Rothschild-Stiglitz unravelling. Cf.:<br />http://scholar.harvard.edu/hendren/pages/papers<br />http://economics.mit.edu/files/8352Anonymoushttps://www.blogger.com/profile/12979135259213557607noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-55563861576441944522012-10-26T12:01:35.413-05:002012-10-26T12:01:35.413-05:00"It may be the case that Swiss companies DO t..."It may be the case that Swiss companies DO the R&D in Switzerland, but then make their money on it in the US market."<br /><br />That may be the case. On the other hand, it may very well be the case that they don't make the bulk of it in Switzerland *or* the US.<br /><br />One of the interesting facets of intellectual property is that it is highly mobile. Under US tax rules, for example, a patent is considered owned and royalties taxed in the place where that patent has been financed (that is to say, the location where the risks and rewards are borne). If a US pharmaceutical company wishes to put profits in, say, Ireland, one of it's Irish subsidiaries might finance R&D to be conducted in the US (or somewhere else). That Irish company owns the patent under this contractual arrangement and is therefore able to charge royalties on the manufacture and/or sale of the drug and to be taxed at the relatively low tax rates in Ireland. The Tax Code tries to backstop this through "Subpart F", but meeting the "active licensing" exception to those rules is quite possible.<br /><br />The same is probably true of Switzerland and other countries that do not have as sophisticated anti-avoidance rules as does the US (e.g., Subpart F). Even though the rate of tax in Switzerland is comparatively modest, it can, and is, often improved through this type of planning. It is certainly not to the advantage of most companies (particularly Swiss ones) to make most of their money in the US due to the relatively high corporate income tax rates here. We often here of the disadvantage US business has due to the relatively high corporate income taxes. What is often missed in these analyses is the amount of income (and tax revenue) that is missed because foreign corporations plan around those rates, too. If the US rates were more competitive, there would be less incentive to do so.<br /><br />Vivian Darkbloomhttps://www.blogger.com/profile/18362419878968863283noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-25050265408154667492012-10-24T21:43:26.667-05:002012-10-24T21:43:26.667-05:00Professor,
Thank you for the excellent analysis. ...Professor,<br /><br />Thank you for the excellent analysis. It may be disjointed, as some commenters have pointed out, but you had a disjointed <br /><br />set of problems to address.<br /><br />I note that you claim: "Health care is not that different from the services provided by lawyers, auto mechanics, home remodelers, tax accountants, financial planners, restaurants, airlines or college professors." I can think of several ways in which health care is different, and would appreciate your analysis of how these differences might impact the policy solutions you discuss.<br /><br />1. Health care contains a public good component that the other industries do not. If I contract a contagious disease, it should not be up to me what quality of care I should seek. Minimum standards must be maintained to protect others who might come in contact with me. Much of medical care is infection prevention/treatment. Licensing requirements are justified to protect us all from contagious infections. As you point out, when the government regulates an industry, the established firms and providers have the incentive to capture the regulatory agencies and use them to suppress competition. <br /><br />2. You talk a lot about the demand for health care vis-a-vis other industries. Correct me if I am wrong here, but my understanding is that demand derives from economic agents solving underlying constrained utility maximization problems. But nobody buys health care because it increases utility. They buy health care because they have suffered a shock to their health. It is poor health that lowers utility -- not lower consumption of health care (in other words, utility is a function of health and consumption of non-health products). Secondly, when a shock to a person's health occurs it lowers the person's productivity and this forces a tighter budget constraint as income decreases. These concepts are no doubt familiar to you from Kenneth Arrow's 1963 paper on the subject here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585909/pdf/15042238.pdf and/or in this model developed by Koijen, Philipson, and Uhlig: http://chess.uchicago.edu/events/documents/KoijenPhilipsonUhlig_102011.pdf. <br /><br />3. Hubbard, Cogan, and Kessler mention discretionary vs nodiscretionary health care here: http://www.taxpolicycenter.org/tpccontent/healthconference_cogan.pdf. Demand for discretionary healthcare would be far more elastic. Emergency medicine would be highly inelastic. In fact, I wonder if elasticity estimates for non-discretionary health care demand would not be an artifact of the data that really have no proper economic interpretation. Your example of the broken arm touches on this. Nobody goes to the emergency room to get the "two for one special". You go to get exactly the treatment you need. In these cases, the individual's demand is very nearly vertical if not completely inelastic. There is a maximum amount that you are willing/able to pay to have the bone set, and while you will happily pay less, no amount of price decrease will induce you to purchase more or less health care. You either get the treatment or you don't. The only variation can be in the quality of the care (or the illusion thereof). Since the aggregate demand is a summation of the individual demands, wouldn't demand be more properly modeled as a discontinuous step function? <br /><br />I am not sure these differences I mention imply any policy changes from what you suggest. But I have never seen you mention them in any blog post. Your analysis of health care/insurance always seems great, but I wonder if these points I raise from the health economics field change anything. I read an interesting article by Victor Fuchs at http://lingli.ccer.edu.cn/ahe2012/Week14/Fuchs1996.pdf. His research showed that health economists disagree with economic theorists not just on normative statements but on positive claims about the effects of health care policies. I wonder if you have noticed the same thing and might have an explanation.<br /><br />Best regards,<br /><br />Ben Wheeler<br />sensationalsonnets.blogspot.comIbnyaminhttps://www.blogger.com/profile/02200468798337178145noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-52812746756152728922012-10-24T18:03:25.200-05:002012-10-24T18:03:25.200-05:00As a dog owner, I concur with your observation abo...As a dog owner, I concur with your observation about veterinary care. I do think that dental care in the US is far less regulated than health care, and wonder if that market offers a sketch of what a more market driven healthcare system would look like (probably more like plastic surgery).Tuckerhttps://www.blogger.com/profile/15351270489987330074noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-44015880820359126942012-10-24T12:34:33.607-05:002012-10-24T12:34:33.607-05:00It may be the case that Swiss companies DO the R&a...It may be the case that Swiss companies DO the R&D in Switzerland, but then make their money on it in the US market. This sounds like a reasonable possibility for pharmaceuticals. What matters is who pays for the innovation, not where the innovation is located. (Well, what matters for this discussion, obviously it's not a great thing for the US if all the high tech innovation is moving elsehwere.) John H. Cochranehttps://www.blogger.com/profile/04842601651429471525noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-42977534665691485242012-10-24T12:29:56.913-05:002012-10-24T12:29:56.913-05:00Vivian: I agree with your reply to Anonymous 1:40 ...Vivian: I agree with your reply to Anonymous 1:40 PM.<br />I would only pin it down further. Where are most of the drugs developed, is it in the US, or is it in Europe or Japan? Where is most of the medical hardware, medical technology developed, is it in the US or Europe or Japan? Where is most of medical innovation taking place?<br />I am not completely sure that R&D medical or health expenditure really measures this; I think one has to be more specific that just such expenditure (like per capita patents in medical technology and pharma?).<br />As for Switzerland: I cannot prove it, but I have this gut feeling that, even though the Swiss do have some well known pharma companies, where are most (or at least a big chunk) of their research labs sitting? Are they really in Switzerland?<br /><br />As to your final question: why are prices of medical hardware and drugs so much higher in the US than in the rest of the world? Because, I think, the US consumer absorbs most (if not all) of the R&D innovation cost and expenditure, and the rest of the world (much of it with nationalized health care systems) free rides on such innovation and inventions. The US consumer basically pays for the rest of world to enjoy that positive externality. <br /><br />I think it was a few years ago that Michael McClellan (Medicare Administrator I think under GW Bush) once asked/demanded/requested that other countries (like the ones in Europe) pay higher prices for US medical innovation in technology and drugs. In other words, he was explicitly addressing that free-ridership issue that other countries enjoy and US health care consumers have to pay for.<br />I wish I had a link or citation to show this.Manfred the mamoothhttps://www.blogger.com/profile/07516724901598949627noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-64920700831978381022012-10-24T10:20:49.164-05:002012-10-24T10:20:49.164-05:00""Europe and Canada (and others) do not ...""Europe and Canada (and others) do not research, invent, innovate and produce by a longshot the amount of new technologies, new medicines and new procedures that are invented and developed in the United States."<br /><br />This is just a myth. Countries like Germany, France and in particular Switzerland do much more research and innovation than the US on a per capita basis."<br /><br />Well, actually, the myth is mostly true. A quick look suggests that two researchers, Burke and Monot, have done quite a bit of work on estimating the total health R&D spent by various countries. Here's one source that suggests, comparing R&D to GDP, the US ranks only below Iceland, Switzerland, Sweden and Denmark. If per capita spending is the measure, the US would likely place above Sweden and Denmark. I don't know about Iceland; however, spending in tiny Switzerland is explained by the presence of some very large pharma companies resident there (perhaps, logically, for tax reasons). <br /><br />http://www.asmr.org.au/ExceptII08.pdf<br /><br />You may also consult this source (focus on Figure 6) which shows the US spends more than half of total health R&D spending. Canada, is way, way down the list.<br /><br />kms1.isn.ethz.ch/serviceengine/.../MFF-2009_FullText_EN.pdf<br /><br />Of course, this is the wrong question. The amount spent on R&D does not necessarily factor in to how high per capita care is in a given country. The question you should be asking is why drugs and other relevant hardware, particularly those manufactured by US companies, cost so much more in the US than many other places in the world to which those goods are exported.Vivian Darkbloomhttps://www.blogger.com/profile/18362419878968863283noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-10570091151466156162012-10-24T09:49:57.333-05:002012-10-24T09:49:57.333-05:00John wrote:
"There is something truly remark...John wrote:<br /><br />"There is something truly remarkable and puzzling about this long, sincere, disjointed essay on US health care reform: there's no mention of the fact that every other advanced country is able to provide healthcare for its people at least comparable and in some cases superior to what we can manage, at half our per capita cost or less."<br /><br />Cochrane replied:<br /><br />"Also, even if it does work, don't forget the cost. You can have European benefits. If you pay European taxes. 40% payroll taxes, 50% income taxes, 20-23% VAT (sales) tax on everything you buy, $6/gallon and up gas... and it's still quite enough as they're having a debt crisis."<br /><br />With respect to the cost factor, John did posit that European countries provide health care at "half the cost", so he clearly did not "forget about the cost". I suspect the "half the cost" is exaggerated; however, I would also suspect that the average cost of healthcare is less per capita in most European countries than it is in the US. Whether health care is financed through taxes or through private payments (most often via insurance intermediaries) one will pay one way or the other. The other claim John makes that those countries have equal or better healthcare outcomes is likely also hyperbole, particularly when one excludes the negative effects of the higher US crime and obesity rates, etc. When these are excluded, studies show the effectiveness of care is probably better (costs aside). <br /><br />Data in this area is notoriously inaccurate; but, isn't the real issue which system is more efficient and therefore cheaper without sacrificing quality? If John is right that the per capita cost in European countries is cheaper than in the US, they must be doing something right, or at least not doing things as badly.<br /><br />The problem in comparing these various systems is largely that nearly all of them are hybrids. There is a common misperception that "universal care" equates with government-supplied health care. In fact, most European countries (with the exception of the UK) deliver more healthcare directly through the private sector than does the US. The US government, via Medicare, Medicaid, the VA, TriCare, CHIPS, etc. has a much heavier hand in the market than does, say, the Netherlands which has no equivalent of Medicare or Medicaid.Vivian Darkbloomhttps://www.blogger.com/profile/18362419878968863283noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-62426665627932373482012-10-23T23:42:49.354-05:002012-10-23T23:42:49.354-05:00""" every other advanced country is...""" every other advanced country is able to provide healthcare for its people at least comparable and in some cases superior to what we can manage, at half our per capita cost or less. These countries also provide universal care for their citizens."""<br /><br />Those countries provide universal *insurance*, and universal take-a-number, not universal medical care.<br /><br />The US system has cost problems and too many fall through the cracks. How could it not given the hurdles illustrated in the health-air video?<br /><br />But the quality of US medicine is, for most ailments (not all), second to none, something I is discovered when one actually gets sick and, after wading through the irrelevant chaff on 'lifespan' cast out by the planners, starts with the grim business of looking up of survival rates in literature for various countries, as I had to do.Falstaffhttps://www.blogger.com/profile/06865552505521389155noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-7163413896687075492012-10-23T13:40:03.240-05:002012-10-23T13:40:03.240-05:00"Europe and Canada (and others) do not resear..."Europe and Canada (and others) do not research, invent, innovate and produce by a longshot the amount of new technologies, new medicines and new procedures that are invented and developed in the United States."<br /><br />This is just a myth. Countries like Germany, France and in particular Switzerland do much more research and innovation than the US on a per capita basis.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-71306754536294980582012-10-23T13:35:07.603-05:002012-10-23T13:35:07.603-05:00Excellent piece. Really enjoyed it. Thanks for sh...Excellent piece. Really enjoyed it. Thanks for sharingWill Jacksonnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-27053540231871661952012-10-22T15:08:47.120-05:002012-10-22T15:08:47.120-05:00Thanks for a very thorough and thought-provoking e...Thanks for a very thorough and thought-provoking essay. The world needs more examples, such as provided here, of why healthcare as we know it doesn't work and costs too much, and how introducing free-market incentives would make things much better. If I had to choose just one thing to change to get the ball rolling, it would be to get rid of the current tax preference that allows only employers to deduct the cost of healthcare insurance. Scott Grannishttps://www.blogger.com/profile/14028519647946868684noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-5609752595094692592012-10-22T14:26:34.891-05:002012-10-22T14:26:34.891-05:00Europe and Canada (and others) do not research, in...Europe and Canada (and others) do not research, invent, innovate and produce by a longshot the amount of new technologies, new medicines and new procedures that are invented and developed in the United States. All those countries with nationalized health care systems they just take without producing, they take advantage of the externalities, without paying for it.<br />And try to sue a doctor for malpractice in Europe or Canada. See how far you can go. My wild guess? You will not go even 10% as far as in the United States. And also, see how much malpractice insurance a UK doctor or Holland doctor carries, and how he has to pay in premia.<br />Thus, before we all engage in Canada and Holland and UK healthcare worshipping, let us all compare apples to apples, as good economists do.Manfred the mamoothhttps://www.blogger.com/profile/07516724901598949627noreply@blogger.com