It's hardly new that I make a post on what some right winger (often libertarian - perhaps I should stop attacking the easy extremes, but these guys blog a lot and I wouldn't want there to be no opposition to their prejudicial rantings and ravings) has said. I just read that David Henderson is convinced that healthcare spending is a Ponzi scheme. For those unaware, a Ponzi scheme is a fraudulent scheme that pays returns to investors not out of profits but out of the investments of others in the scheme - it's fraud.
It takes a remarkable, breathtaking amount of blinkeredness to talk about how healthcare is a Ponzi Scheme. To focus only on the contributions people must pay, and what they individually get out of it in the end. To what extent are insurers thus not engaging in Ponzi Schemes?
Moreover, it shows yet another example of a total disregard for the informational problems in healthcare markets. Libertarians and staunch right wingers usually try and get around this by saying that regardless of what the informational problems are, the market still provides best. But does it? Can legislation and regulation and maybe even public provision not help solve the kind of informational issues in healthcare?
Let's just recap. Are we, as customers, well informed about our own health, and what the possible healthcare options are to us, and how much we need them? Answer: No. If we all did 6+ years of medical training, maybe. But given we all have other things to be doing, then no. So in a nice free market (something libertarians are want to compare healthcare to), your doctor can command a fee from you (or your insurer) if he undertakes some procedure on you. You see your doctor every now and again, and realistically there's no way to know whether what he/she is giving you is needed, harmful, etc. It really doesn't take much insight to see there are chronic problems associated with healthcare due to informational problems. Furthermore, the cost of a mistaken "choice" (it's hardly a choice if we aren't informed) is ill health and possibly even death. It's not like after we find one bad producer we can just costlessly switch to another, like we would if we decided that the bad producer was dodgy (and thus set about sullying his or her reputation).
It just doesn't stack up, and only confirms what I've really began thinking recently. If you take extreme positions on either side of the spectrum, left or right, you have to become blinkered and prejudiced, twisting truth and ignoring many important considerations to substantiate your position.
My grandad once said something of interest - You should stop paying the doctor when you are ill, but have to pay when you're well.
ReplyDeleteThat way, the doctors do their utmost to treat you as effectively and as efficiently as they can as there is a financial incentive. The second best option is to pay them all the time.
Do you think that an open market scheme that does what my grandad suggested would be a bad thing?
That sounds quite a bit like an insurance system I guess - you pay your premiums in the good times and hope for a payout when you get sick.
ReplyDeleteI think a system that does what your granddad suggested probably wouldn't be a free market system - I'm doubting that we'd ever naturally get to such a system where doctors willingly forewent payment for the most complicated of procedures. On the other hand I guess it is possible since there might be the incentive in a free market system for a new healthcare provider to set up offering just that. It would need sufficient size though in order for the premiums collected from healthy folk to cover the complicated surgery for the ill...