In a non-wonky way: We Can’t All Have All the Medical Care We Want. One quote:
Should the middle class get health care at public expense? No, there is no one to pay for our health care but us. We can pay out-of-pocket; we can buy private insurance to cover catastrophic risk and thereby get some control over how much health care we buy for ourselves. We can pay taxes to the government which it will then use to decide how much health care we can get; but it will still be us paying for it and decisions will still have to be made as to how much care we get; we'll just lose all control over how much we spend on health care as opposed to, say, food or education.
Seems to me that there are three main drivers of high insurance costs: low deductibles (ie insurance that tries to cover everything including the sniffles, routine exams, and elective things like Viagra and hormone replacement); fear of malpractice lawsuits which is why everybody with a headache gets a $1200 CAT scan; and the frequently insane costs of end of life treatment such as catastrophic strokes or the millions for things like terminal cancer.
Coyote is very good on this too: Who Makes the Price-Value Tradeoffs? He quotes McArdle:
It seems quite likely to me that vouchers are going to be better at controlling health care cost growth than a central committee. Every committee decision that cuts off a potentially useful treatment (and I’m afraid it can’t all be back surgery and hormone replacement therapy) will trigger a lobbying explosion from affected groups. Each treatment is a decision with a small marginal cost to the taxpayer; it’s in aggregate that they become expensive. Which means that the congressional tendency is always going to be to override–and while there are supposed to be structural barriers against this in the bill, they aren’t very strong . . . about like trying to quit smoking by hiding your cigarettes from yourself.
