We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
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.
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.
Taken to reading Milton Friedman's Free to Choose, it seems as useful now as back in the 70's. Judging from responses from co-workers and friends the last couple days it would be a good thing to know as much as possible about the medical plans and 2012 budget. I am always amazed how many people accept at full value whatever the MSM says and if you calmly point out the differences how much more persuasive we can be. I've learned ranting only makes people think you and your ideas are crazy.
I'm so glad this blog exists.
Where did the idea that "we" always "want the best" medical care start, anyway?
The vast number of choices I've made during my life have tended to be towards what works - and sometimes, what works isn't held to be the "best". My area (No. VA) has seen an explosion in the "quick care" clinic business, and quite frankly, I've all but dropped my regular Docs office for routine visits. Are these clinics "the best"? No. Do they do what they promise for a good $? Yes.
Perhaps we should not be so quick (even in humor) to blame defensive medicine as the cause of the overuse of sophisticated diagnostic equipment like the MRI and CAT machines. These expensive pieces of medical equipment may need to be used close to capacity in order to pay off their initial purchase cost. As long as health insurance foots the bill, patients are going to show less skepticism and less resistance to get a CAT or MRI scan in the course of their treatment. If patients had to pay out of pocket for those costs, however, they might ask a lot more questions of their physician or hospital as to the real need for a CAT or MRI scan. The easy availability of employer provided or government provided health insurance helps to hide the true cost of health care to individual patients but drives aggregate costs upward. The same thing has happened in higher education, where student loans have made it financially easier for individual students to go to college, but act as a perverse incentive for colleges to raise their prices, thereby producing an upward spiral in the cost of education that eventually traps students in financial purgatory.