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Not So Fast!

Do We Need State Control of Medical Care?

Government-run health care cannot eliminate scarcity

By William Anderson
Published: 1 July 2009

the-doctor-will-see-youThe notion that the political classes “should never waste a good crisis” has extended not only to the de facto nationalization of domestic auto companies and the financial sector, but also to medical care. It is treated as inevitable that the government will demand to control all the money that comes into the medical sector, thus effectively nationalizing it.

President Barack Obama recently expressed faux surprise that anyone would oppose his latest proposal, a government-run insurance company that will offer coverage in competition with private insurers. The president’s surprise came in the form of asking why people would claim that government cannot operate efficiently, yet simultaneously run an insurance company that would be a lower-cost producer than private firms.

While seemingly clever, President Obama’s point is irrelevant. The question is not about the “efficiency” of insurance plans, but rather the simple fact that government schemes are responsible for driving up the cost of medical care to consumers. From the huge regulatory burdens (with accompanying paperwork) on medical people to the third-party payments, government actions on all fronts have turned medical care into something akin to a Rube Goldberg cartoon.

Talk to any doctor and he or she will tell you that they spend many hours per week doing paperwork, almost all of it required by government and insurers. The government paperwork is especially pernicious because errors or disagreements on billing – even innocent ones – can lead to criminal charges. The legal aspect of medical care has turned into a minefield for the providers, and that has to impact overall costs.

The main issue, however, is quite simple, yet also profound: Medical care is a scarce good and thus is subject to the laws of economics. All too often, we hear that medical care is not like other goods and services and is set apart from economic laws. All we can say in return is, “Not so fast, my friend.”

Application of economic theories does not discriminate between the kinds of goods and services rendered. If something is scarce, the same laws apply whether we speak of brain surgery or pork bellies. Such words are disconcerting to people who believe that medical care should be a right that should be provided to everyone regardless of one’s personal wealth. Unfortunately, all government interventions – all of them –carrying out this “rights” mandate only serve to make medical care less available (and less effective) for everyone.

Think of a simple supply-and-demand example. If anything increases the cost of providing something, the supply curve shifts to the left, making the good less available and higher-priced. There is no exception to that point for anything that is scarce.

So, let us think of the ways that government makes it more difficult to provide medical care. First, and most important, government sets huge barriers in the path of people seeking to engage in medical occupations, especially through licensing and strict regulations. In other words, government purposely limits the supply of medical providers to protect the incomes of doctors.

It is the equivalent of the government’s forcing all of us to purchase a BMW or Cadillac instead of letting us choose between a high-end and lower-end vehicle. If such restrictions existed in the auto industry, we would have demands for “cost containment” in autos.

Second, as previously noted, the legal side of medical care forces doctors and nurses to spend time doing paperwork rather than providing care. Furthermore, the constant threat of criminal and civil action forces medical care providers to play defense, which further limits the supply of their services.

Last, the third-party payment system that dominates medical care further separates the consumers from their choices. If we had the same system to pay for food and automobiles, we would have “cost crises” in those markets as well.

Most people cannot fathom decoupling government control and medical care, as though cost-raising controls actually improve medical service. Yet if we wish to have innovative and affordable medical care, that is precisely what must be done.

8 Comments »

  1. [...] Do We Need State Control of Medical Care? | Foundation for … [...]

  2. Мебель комната, Гостинные, Стул. ООО «Балтик Хауз». Обеденные столы. Представляем Вашему вниманию высококачественную корпусную и мягкую мебель, а именно спальни, обеденные столы и стулья, гостиные от ведущих производителей Литвы.

  3. Why is it that this is so hard for people to understand? I explained to one of my friends that, by state law, my health insurance covers pregnancy. He didn’t believe me, but I showed him the documentation. I get 3 days in the hospital. But I am male and will never be pregnant.

    The state mandates that we, in NJ, have coverage for chiropractic care. Now, if you want that, fine, but I believe chiropractics is a sham. I don’t want it covered as I have no intention of ever using a chiropractor. But I have no choice but to pay for this coverage I do not want.

    When I told this friend that, if a nation-wide large insurance pool is the answer, why not abolish the multi-state regulatory structure and let it develop? You’d think I ask him to consider drowning babies.

    I do not understand why anyone would turn to the government for solutions to problems created by the government. It boggles the mind. When government fails, like after Katrina, what do they call for: more government! Is there no end to this madness?

    It can be very frustrating. Ignorance is bliss. Understanding economics is a curse, as I watch the president advance one idiotic idea after another, and then endure the press lauding his intelligence. I am sorry for my pessimism, but I work in banking and if I have to endure one more talking head saying we aren’t regulated enough I will likely throw up.

  4. Excellent post.

    Several excellent physicians I know have given up and switched to “concierge medicine.” Although controversial, they otherwise would have stopped practicing.

  5. For about a hundred years, America has been a nation of accumulating medical controls. Each new regulation was passed with the same justification made for the previous one: This measure will sufficiently correct the failings of the free market and thus save the free-market system. And the result? Today’s “crisis in health care” — as the welfare statists themselves call this iatrogenic disease. The more band-aids are applied, the more wounds appear! And with nothing but band-aids in their bags, these “liberals” (often the same aging advocates of past regulation) can now prescribe only covering the patient head to toe — i.e., the final move to the outright socialization of all medicine. What this says about the microcosm of medicine is obvious; what it means for our mixed economy is ominous.

    FULL STORY

  6. Public or private—I’ll take whatever healthcare plan comes with the Baltic furniture…

  7. [...] Do We Need State Control of Medical Care? | Foundation for … [...]

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