I recognize that you aren’t making this argument, but it is a logical next step after your (true) points about how much more medicine we’re consuming (and not getting much more life expectancy). Many people hear this and say “well it must just be waste or just inefficient, we can cut it” but while some of it is (and could be cut) a much larger percentage of the “additional medical spending vs the past” is not.
There are two big reasons: the rise of chronic diseases that require (in both the minds of patients and doctors) expensive long term treatment, and that the treatment does not (and is not designed to) cure. The patients receiving this care believe it is necessary and that they (desperately) need it.
Second, people want more from medicine than life expectancy. They want cosmetic things, subjective things, as well as just better medical experiences, less pain, less discomfort and humiliation. And more convenience. All of these things are expensive to provide, valuable to patients, but extremely difficult to measure when there is no market to allow patients to value tradeoffs.
A very clearly written explanation of where we are. Thank you. Could you or someone else at the Boyd Institute please follow up with an analysis of various alternatives to our current system? I have a friend who is a retired family practitioner. He swears the only viable option is single payer but my conservative mindset rejects the thought of putting the government in total control of yet another part of our lived
The answer is that we are right now much closer to a single payer system than not. The government already pays directly for an enormous amount, and heavily regulates the prices and processes of the rest. And everyone hates it - I guarantee the parts of medicine that retired guy hated most at his job was the claims, coding, billing and insurance parts. All of which are direct govt policy.
The solution is to go back to a world where customers choose what services they want, and whether the price (that they can actually see!) is worth it, so that all the systems (that Kling describes) we have for markets and prices and transactions can work. If some people can’t afford a basic level of care, voters can approve a level of subsidy for them - but we don’t want the government to be doctor and insurer, because they already largely are, and no one likes it.
How do you reckon the consumer pays little or nothing? The cost ti my employer for my health insurance is a cost to me because i would be getting that in salary otherwise. This is rhe conservative version of progressives "free government healthcare" logic. My out of pocket costs aren't high but my employer pays me less so they can fund healthcare.
I recognize that you aren’t making this argument, but it is a logical next step after your (true) points about how much more medicine we’re consuming (and not getting much more life expectancy). Many people hear this and say “well it must just be waste or just inefficient, we can cut it” but while some of it is (and could be cut) a much larger percentage of the “additional medical spending vs the past” is not.
There are two big reasons: the rise of chronic diseases that require (in both the minds of patients and doctors) expensive long term treatment, and that the treatment does not (and is not designed to) cure. The patients receiving this care believe it is necessary and that they (desperately) need it.
Second, people want more from medicine than life expectancy. They want cosmetic things, subjective things, as well as just better medical experiences, less pain, less discomfort and humiliation. And more convenience. All of these things are expensive to provide, valuable to patients, but extremely difficult to measure when there is no market to allow patients to value tradeoffs.
A very clearly written explanation of where we are. Thank you. Could you or someone else at the Boyd Institute please follow up with an analysis of various alternatives to our current system? I have a friend who is a retired family practitioner. He swears the only viable option is single payer but my conservative mindset rejects the thought of putting the government in total control of yet another part of our lived
The answer is that we are right now much closer to a single payer system than not. The government already pays directly for an enormous amount, and heavily regulates the prices and processes of the rest. And everyone hates it - I guarantee the parts of medicine that retired guy hated most at his job was the claims, coding, billing and insurance parts. All of which are direct govt policy.
The solution is to go back to a world where customers choose what services they want, and whether the price (that they can actually see!) is worth it, so that all the systems (that Kling describes) we have for markets and prices and transactions can work. If some people can’t afford a basic level of care, voters can approve a level of subsidy for them - but we don’t want the government to be doctor and insurer, because they already largely are, and no one likes it.
Lives, not lived
How do you reckon the consumer pays little or nothing? The cost ti my employer for my health insurance is a cost to me because i would be getting that in salary otherwise. This is rhe conservative version of progressives "free government healthcare" logic. My out of pocket costs aren't high but my employer pays me less so they can fund healthcare.