Cold Fury

Harshing your mellow since 9/01

The real solution

One that will never occur to a dumbass Leftist like Ogabe; actually, one he’d fight tooth and nail against.

Callahan and Nuland perfer to see “a centrally directed and budgeted system, oversight in the use of new and old technologies, and price controls.” They are like fiscal homeopaths in reverse. Instead of treating the patient with attenuated versions of the substance linked with an illness, they want to increase the dosage massively. If their prescription doesn’t kill off American medicine, it will certainly end up killing a lot of patients.

There is another way. One of the chief causes of our current health care malaise is the increasing centralization of the health care budget. In 1965, the health budget of the federal Department of Health Education and Welfare totaled $1.9 billion (about $14 billion in today’s dollars). Then Congress approved legislation establishing Medicare and Medicaid whose costs have increased exponentially since then. Medicaid enrollment increased from 18 million Americans to 68 million now and costs state and federal governments nearly $400 billion last year. Similarly Medicare enrolled 19 million Americans at a cost of $10 billion. Today nearly 48 million Americans are receiving Medicare coverage at a cost of more than $500 billion. If government agencies were able to rein in health care costs, they have had nearly 50 years to prove it. So much for the effectiveness of centralized budgeting.

Government agencies have also never been much good at picking new technologies. In fact, there’s pretty good evidence that health care industrial policy such as the federal certificate of need programs which limit health care capital and new technology expenditures have contributed to higher medical costs. And price controls have been a disaster everywhere they have been tried.

On the other hand, we do in fact know what works when it comes to restraining prices, encouraging innovation, and increasing consumer satisfaction—competition in markets. Markets are superb at gathering widely dispersed information and resources from millions of people and firms and then distilling that information into prices. Here’s a partial list of what needs to be done: Allow physicians to sell their services in any form that they choose, as group members, health maintenance organizations, fee-for-service, etc. Nurses and other health care professionals should be encouraged to compete with physicians for primary care services. Insurers should be allowed to compete across state lines offering a wide variety of policies tailored to the perceived needs of various customers. Pharmaceutical and medical device manufacturers could be encouraged to work in tandem with physicians integrating the latest research findings quickly into therapeutic regimens without having to wait for the permission of hypercautious Food and Drug Administration bureaucrats. Consumers looking out for their own health and insurance needs would be vigilant about the costs and benefits of treatments, ensuring that medical progress remains economically affordable.

Callahan and Nuland are right that “the inadequate, inequitable, and financially insupportable system that has been jerry-built and constantly band-aided during recent decades will no longer do.” It’s way past time that the failed policy of centralized medicine be jettisoned entirely.

Makes perfect sense to anyone who has any, but it’s an answer to the wrong question. After all, how will empowering people, expanding their range of choices, improving their health, and driving down their costs ever help to expand the State’s power over them?

Update! Just don’t call ’em death panels, okay? They hate it when you tell the truth about ’em.

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11 thoughts on “The real solution

  1. > “Just don’t call ‘em death panels, okay? They hate it when you tell the truth about ‘em.”

    What does a single instance of hospital negligence in another country have to do with end-of-life counseling as prescribed in the 2003 Medicare prescription drug bill passed by GOP members of the House and Senate?

  2. Oh, great, just what I need, another precious pedant picking nits on every post. I was being a wee mite sarcastic on that one, as I am on just about everything I put up here. Why don’t you go find something else to read, Professor, since this blog obviously will never live up to your lofty standards?

  3. > “Why don’t you go find something else to read, Professor, since this blog obviously will never live up to your lofty standards?”

    Glad you asked. I comment because I think you write well; I criticize when when you’re selective about the facts.

    If all you want is a nice comfortable echo chamber just say the word(s).

  4. Well, I do appreciate the compliment. But you seem to want to parse things a bit too…uhh, parsimoniously. A fair amount of the stuff I throw out here, I do because it makes me laugh, and for no other reason. I don’t mind constructive criticism at all, honestly, but if you’re gonna dissect everything I toss off for strict adherence to niggling detail, well, you got your work cut out for ya, my friend. Likewise with any insistence you might make that I be less partisan or one-sided. That ain’t really what I’m about here.

    This site is a way for me to vent against the Left, basically, and I ain’t above using any means that come to hand, fair or foul, to do it. I’ll always try my best to be factual, and I’ve cheerfully made corrections here and there over the years when I’ve been wrong. Hell, I’ve even had a civil discussion or three here with diehard liberals, believe it or not. But for the most part, I see my role here as slamming them as hard as I can, with any shovel, hammer, or other blunt object I can reach. I’ll jump on GOPers too, when it suits me. But I have no interest in helping the Left make its case, and every interest in seeing them brought low — like I said, fair or foul, whatever it takes. They’d do it for us, after all, as I’m sure you know well enough. And I’m not at all amenable to the standard argument about not “descending to their level” and suchlike. When you wrassle a pig, you’re bound to get a little mud on ya.

    Feel free to check me up all you like. But you should definitely bear in mind that much of what I do here is not intended to be serious, scholarly dissection of facts, figures, and policies. Much of it is mudslinging, pure and simple. I enjoy it, it makes me laugh, and I hope it’s entertaining to the 4 or 5 thousand people who stop in here every day to read it. I think that has value in and of itself, just as the more serious work done by, say, Andrew McCarthy or Prof Jacobson does. We’ve all got our own part to play in this struggle, and I’m content working within the constraints I’ve set for myself. Which doesn’t mean that every last syllable of it should be taken seriously, or literally — or that none of it should. I’m serious about enjoying myself here, you might say; if I wasn’t having fun, I’d have quit a long time ago.

  5. > “I see my role here as slamming [diehard liberals] as hard as I can, with any shovel, hammer, or other blunt object I can reach.”

    Conversely, my weapons of choice are the slender blade of empirical data and the silk garrotte of logic. Should be a good match 🙂

    > “I’m serious about enjoying myself here, you might say; if I wasn’t fun, I’d have quit a long time ago.”

    Oh, likewise.

  6. Should be a good match

    Agreed, completely. Both approaches are essential, I think, and complementary.

  7. Don’t feed the douchebags Mike, they’ll just keep coming back. Notice that this particular sophist used neither ’empirical data’ or ‘logic’ as he offered you his undisguised opinion. What he did use was two polysyllabic words that he scarcely understands in order to show how ‘smaht’ he believes himself to be. Meh. Trust me – far more productive to just tell him to go fuck himself.

  8. @Abiss

    Notice that this particular sophist used neither ’empirical data’ or ‘logic’ as he offered you his undisguised opinion

    Lolling at you dummy: if it is an empirically verifiable statement of fact that end-of-life counselling was originally a Republican-sponsored idea and consequently nothing to do with those rascally radical socialists… then it logically follows that you can take your attitude and cram it back up your rancid sphincter 🙂

  9. Any system which rations health care services is a ‘Death Panel’.

    It is bad when insurance companies do it. Why is it good when the government does it? And ‘single-payor’, Ogabe’s dream, is a system in which health-care services are provided by one big insurance company: The Government. An insurance company with guns.

    The only legitimate ‘Death Panel’ is composed of the patient, his family, and his doctor.

  10. @dickwad who spends far too much time thinking about my sphincter.

    The idea itself is socialistic – being a necessary feature of a socialistic system that has one group of people ‘involuntarily sharing the burden and responsibility’ for providing healthcare to another group of people. What is empirically observable then is that it was sponsored by ‘socialists’ – be they Democrat, Republican or other. In fact, before that it was a feature of Hilary-care in which case the socialists sponsoring it had a (D) after their names. The only thing empirically proven so far is that you’re a fucking moron with a very narrow view of the world, and limited tools to understand what you observe. Thank you. That couldn’t have been achieved without your help.

  11. The only thing empirically proven so far is that you’re a fucking moron with a very narrow view of the world, and limited tools to understand what you observe.

    What I said was empirically verifiable and the conclusion I drew was logical whether you agree with it or not. I’m sorry you have a hard time grasping this.

    The only thing empirically proven so far is that you’re a fucking moron with a very narrow view of the world, and limited tools to understand what you observe.

    LOL @ yet another graduate of the Alanis Morisette school of irony 🙂

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