tag:blogger.com,1999:blog-582368152716771238.post4026475746066702979..comments2024-03-29T07:18:14.271-05:00Comments on The Grumpy Economist: Chris Demuth on ObamacareJohn H. Cochranehttp://www.blogger.com/profile/04842601651429471525noreply@blogger.comBlogger29125tag:blogger.com,1999:blog-582368152716771238.post-15659274549650469002013-12-20T12:17:43.011-06:002013-12-20T12:17:43.011-06:00To clarify my earlier post -
Is health care a su...To clarify my earlier post - <br /><br />Is health care a superior good? If the answer is yes then we should expect health care costs to rise over time relative to the costs of other goods and services, and the health care industry will become an ever increasing proportion of the entire economy. This is simply a natural consequence of economic growth (per capita) and the income elasticity of health care demand, i.e people's preferences. I do not see why we should try to counteract this mechanism through some form of artificial cost control.TX_ECNMSTnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-50548861310876915602013-12-20T10:22:57.318-06:002013-12-20T10:22:57.318-06:00Your argument may be completely wrong. Check out h...Your argument may be completely wrong. Check out http://www.forbes.com/sites/joonyun/2012/10/18/health-and-wealth/<br />TX_ECNMSTnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-15217210038744697982013-12-20T10:18:33.227-06:002013-12-20T10:18:33.227-06:00Professor Cochrane:
What do you make of the argum...Professor Cochrane:<br /><br />What do you make of the argument that as income increases and living standards rise, people reach a point at which they don't want more stuff but more and better quality life? This line of argument then suggests that we should observe health care spending rising as a proportion of total spending. If this mechanism is operative it seems that the macro aspect to the health care crisis is largely overblown. Focus should be on fixing the micro inefficiencies that limit access.<br /><br />related article http://www.forbes.com/sites/joonyun/2012/10/18/health-and-wealth/<br />TX_ECNMSTnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-1429108546737213612013-12-17T15:45:32.975-06:002013-12-17T15:45:32.975-06:00Professor, what are your thoughts on the governmen...Professor, what are your thoughts on the government covering all catastrophic care? If the problem is simply that we are overinsured, does that leave room for the statement that the government should foot the bill for catastrophic events?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-86896627299801378082013-12-17T12:07:57.464-06:002013-12-17T12:07:57.464-06:00One can describe different health care approaches ...One can describe different health care approaches however one wishes. The bottom-line is that the current US approach is vastly more expensive; there already exist alternative approaches which do as good a job by and large for much, much less. It's hardly self-evident that what is being called a free market system is anything more than ideological pie in the sky, and meanwhile we see other systems which in terms of cost/outcomes are doing a significantly more creditable job right now. How on earth is it beside point that these well established systems provide unquestionably superior value? Johnhttps://www.blogger.com/profile/13718398994164216979noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-26819988118811600402013-12-17T10:35:25.240-06:002013-12-17T10:35:25.240-06:00This US vs. Europe controversy is rather beside th...This US vs. Europe controversy is rather beside the point. The US has a highly regulated crony-capitalist system. Much of Europe has a state-run system, with a private business class on top of that for wealthy people who don't want its miseries. <br /><br />This is like comparing the 1960 US phone system -- regulated monopoly -- to the 1960 European phone system -- government monopoly. <br /><br />And the argument "nobody else does it" is just as silly. Until the 1980s, every other government monopolized telephones, television, air travel, truck transport, etc. etc. etc. Then a little deregulation brought us all wonders. <br /><br />The US is not now even close to a free market system. The fact that the current US system can even be compared to state-run systems is a measure of its dysfunction -- and how much better a free market sytsem can be. John H. Cochranehttps://www.blogger.com/profile/04842601651429471525noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-38013860556934562632013-12-17T10:08:48.175-06:002013-12-17T10:08:48.175-06:00Granted while it lags in some areas there are othe...Granted while it lags in some areas there are others in which US health care performance is superior. Nevertheless, compared to the UK we spend three times as much (!) for generally similar results. <br /><br />And we'd do well to consider too that the Veterans' Administration in the US, which most closely resembles the UK National Health Service, vastly outperforms its private sector counterparts on every front.Johnhttps://www.blogger.com/profile/13718398994164216979noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-77099556610039918382013-12-17T08:06:05.664-06:002013-12-17T08:06:05.664-06:00How about life expectancy?How about life expectancy?"O" Anonimohttps://www.blogger.com/profile/07896236826318022479noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-76394383572471143462013-12-17T08:05:10.264-06:002013-12-17T08:05:10.264-06:00"Also, I think it is worth pointing out that ..."Also, I think it is worth pointing out that since 87% of all Americans had some sort of health insurance in 1/1/2009, the notion we needed this grand social re-engineering project to fix the problem is the equivalent of using a nuclear weapon to light a cigarette."<br /><br />I think it is worth pointing out that the US was spending 16% of GDP on health care -- that is a failure any way you define it. Maybe Obamacare will fail too, but at least it is an attempt to face the problem."O" Anonimohttps://www.blogger.com/profile/07896236826318022479noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-53611822483291855052013-12-17T08:02:27.143-06:002013-12-17T08:02:27.143-06:00"In 2010, the GAO estimated that roughly 10% ..."In 2010, the GAO estimated that roughly 10% of all medicare payouts ($48 BILLION) were based on fraudulent claims. What incentives does the federal government have to reduce that fraud if there is no risk that they'll run out of money?"<br /><br />The same incentives that the federal government faces in military contracting or hiring of civil servants. "O" Anonimohttps://www.blogger.com/profile/07896236826318022479noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-9866170982613674652013-12-17T08:00:39.509-06:002013-12-17T08:00:39.509-06:00The problem with conservative prescriptions for he...The problem with conservative prescriptions for health care (such as Professor Cochrane's) is that nobody takes them seriously. Why that? Well, because the market of ideas is efficient."O" Anonimohttps://www.blogger.com/profile/07896236826318022479noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-69920357298044974362013-12-17T07:07:18.964-06:002013-12-17T07:07:18.964-06:00Your claim that healthcare results are generally a...Your claim that healthcare results are generally as good and in some cases better than in the USA does not bear out when it comes to the UK NHS - along with cancer, results are worse in the UK for cases of diabetes, hypertension and stroke.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-85138762533923254512013-12-17T07:05:26.421-06:002013-12-17T07:05:26.421-06:00By "any European system", do you include...By "any European system", do you include the UK's National Health System, where in 2010, the government was compelled to issue an “NHS Constitution” in which it was declared that no patient should wait beyond 18 weeks for treatment – four months – after GP referral? <br /><br />In addition, for diseases like cancer, survival rates are much higher in the US (the breast cancer mortality rate is 88 percent higher in the United Kingdom than in the U.S.; prostate cancer mortality rates are strikingly worse in the UK than in the U.S.; mortality rate for colorectal cancer among British men and women is about 40 percent higher than in the U.S). <br /><br />Yay! I can't wait for that here in the US!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-53799958140806158762013-12-16T21:59:59.510-06:002013-12-16T21:59:59.510-06:00http://www.businessinsider.com/heres-why-republica...http://www.businessinsider.com/heres-why-republicans-will-never-reform-health-care-2013-12Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-9839879534182691662013-12-16T21:58:19.921-06:002013-12-16T21:58:19.921-06:00Like all Grumpy commentary on health care, there&#...Like all Grumpy commentary on health care, there's still an elephant in the room:<br /> <br />U.S. health care costs are two or more times as much per person as those of every other advanced country, and these countries somehow also provide universal care, which we do not. Their health care outcomes are generally as good as and in some cases better than ours. Yet none of these countries achieves its superior performance through any type of market based system like what you advocate. Far from it. And their citizens frequently report considerable satisfaction with how their health care is provided. Nor is some ostensible loss of freedom an issue in the forefront of debate.<br /><br />How can those who fail to address this reality expect their thoughts on health care reform to receive serious consideration? <br /><br /> Johnhttps://www.blogger.com/profile/13718398994164216979noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-39927965518910952652013-12-16T14:07:38.183-06:002013-12-16T14:07:38.183-06:00I believe failure of all conservative policy presc...I believe failure of all conservative policy prescriptions in healthcare stems from inability to make a convincing case that Akerlof is wrong. Maybe because he is right ?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-61769651703380630992013-12-16T11:36:11.922-06:002013-12-16T11:36:11.922-06:00Your idea that we have to treat healthcare as a co...Your idea that we have to treat healthcare as a competitive market is deeply flawed and is bound to lead to a disastrous outcome. Just look at any European system and you will see why. But then again don't let facts get in the way of your ideology.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-55718487825262965172013-12-16T10:34:02.606-06:002013-12-16T10:34:02.606-06:00Nobel laureate George Akerlof won his prize for sh...Nobel laureate George Akerlof won his prize for showing how market failures can result when asymmetries of information exist between buyers and sellers. His paper <a href="http://www.iei.liu.se/nek/730g83/artiklar/1.328833/AkerlofMarketforLemons.pdf" rel="nofollow">The Market for Lemons</a>, addresses health insurance market failures amongst other things.Ibnyaminhttps://www.blogger.com/profile/02200468798337178145noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-65295484538555546742013-12-16T10:01:08.451-06:002013-12-16T10:01:08.451-06:00One challenge that Conservatives have is the premi...One challenge that Conservatives have is the premise upon which Obamacare is presented: as a Big Government solution to a big problem. Central planners have trained the public to think that only through a raft of policies and regulations will things get better. It won't work with Dodd & Frank, and it won't work here. Conservatives have to come up with a way to explain their policies in a manner that compares apples to apples in terms of OUTCOMES, not in terms of IMPLEMENTATION (which would be radically different between the Central Planners and the Conservatives) - by showing advantages in terms of OUTCOMES, the debate can be shifted and the battle won.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-55028196426212073032013-12-16T09:56:42.146-06:002013-12-16T09:56:42.146-06:00Jon Gruber has written a number of opinion pieces....Jon Gruber has written a number of opinion pieces. You can link from his <a href="http://economics.mit.edu/faculty/gruberj/opinion" rel="nofollow">faculty page</a>.Ibnyaminhttps://www.blogger.com/profile/02200468798337178145noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-87900586022540503702013-12-16T09:55:10.115-06:002013-12-16T09:55:10.115-06:00"A society where everyone fends for themselve..."A society where everyone fends for themselves is not in anybody's interests" ... who is promoting that as an alternative? <br /><br />Responsible individuals COOPERATE with each other every day. We don't need the threat of taxation or jail to do so. The difference between a single payer solution and a non-single payer solution is the issue of choice and competition. Single payer = no choice, no competition. <br /><br />In 2010, the GAO estimated that roughly 10% of all medicare payouts ($48 BILLION) were based on fraudulent claims. What incentives does the federal government have to reduce that fraud if there is no risk that they'll run out of money?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-82788427590789521612013-12-16T09:14:55.681-06:002013-12-16T09:14:55.681-06:00Also, I think it is worth pointing out that since ...Also, I think it is worth pointing out that since 87% of all Americans had some sort of health insurance in 1/1/2009, the notion we needed this grand social re-engineering project to fix the problem is the equivalent of using a nuclear weapon to light a cigarette.<br /><br />mrbWellRead29https://www.blogger.com/profile/16938539684932800999noreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-46538030422073843642013-12-16T08:51:18.045-06:002013-12-16T08:51:18.045-06:00The US will have a good , value for money healthca...The US will have a good , value for money healthcare system only once the average American will recognise that a single payer, state system does not mean socialism USSR style and that actually we live in a society. A society where everyone fends for themselves is not in anybody's interest. Even cave men understood that.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-76485536269590283482013-12-16T06:12:45.201-06:002013-12-16T06:12:45.201-06:00I think the problem is that conservative alternati...I think the problem is that conservative alternatives may exist but it is very hard to understand why/how they would work. For example, even on this blog - I know that John has an extensive policy proposal - but even though I've been reading this blog for a while, I can't for the life of me explain how it works if at all, and I have an MBA from University of Chicago ! Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-582368152716771238.post-6456838005450765112013-12-15T19:44:16.629-06:002013-12-15T19:44:16.629-06:00 Beginning at the beginning, health insurance poli... Beginning at the beginning, health insurance policies in the U.S. circa 1900, the advent of such policies being marketed on a wide basis, where scheduled hospital policies. They listed particular procedures and associated flat dollar payments. Those policies morphed into scheduled hospital policies based on a daily hospital room rate where the insured picked the room rate and the list of procedures were paid as a multiple of the room rate e.g. tonsillectomy 4 x room rate. Those policies in turn morphed into major medical insurance that paid procedures at “reasonable and customary charges” based on the regional prices of region of the country the procedure occurred. <br /><br />Around 1960, 6% of medical bills were paid by insurers while 94% were paid by the insured. By 2010, 94% of bills were paid by insurers and 6% were paid by the insured. During the same time period politicos through the mechanism of government began mandating particular items be included within policies. At the Zenith, there were some 1600 mandates among the 50 states with some states having over 100 mandates each. Rather than particular items being offer by endorsement at a price for those seeking the particular item, all insured ended with the mandated items and associated price hence subsidizing the few that want the item.<br /><br />It is worthy to note that the vast majority of mandates came from special interests wanting to focus benefit upon themselves at the expense of the many. Politico entrepreneurs looking for ways to fund political constituency building exercises with other people’s money were glad to oblige.<br /><br />During the entire episode from 1960 to present, price of health-care became less and less known to the consumer to the point that consumers rarely, if ever, ask about price. The same consumer that would never step foot in a store with no posted prices became trained to never ask about price for health-care. How odd. Yet politicos who are always on a moral grandstanding crusade regarding price never bothered with this aspect of non-price. Which proves yet again there is a difference between the benighted and the beclowned.<br /><br />Meanwhile back on the supply-side, the suppliers of health-care, acting as good little rent seekers, lobbied for protection from others wanting to enter the supply-side. Politicos once again eager to find ways to expand political constituency building obliged. From “certificate of need” to the AMA restricting physician supply, health-care supply is stunted, non-robust and competition-less. The supply-side is so dysfunctional that technological innovation driving prices up rather than down.<br /><br />The problem outlined above has a common thread, as do most problems: politicos through the mechanism of government. The dupery and nitwitery is that a politico produced problem, is then going to be solved by, politicos [Obamacare]. Sweet!<br /><br />Episode 1.209,472 of economic questions with political answers. Rather than individuals particular time and particular circumstance being the criteria, the process becomes the infamous “one best way” which fits no one.<br /><br />“The plans differ; the planners are all alike…” - Frédéric Bastiat <br /><br /><br /><br /><br /><br /><br />W.E. Heasleyhttps://www.blogger.com/profile/00368333904571061995noreply@blogger.com