What He Said

From Michael Cannon at Cato:

There's a lesson here for those who want to cover the uninsured: focus on the incentives facing the 250 million Americans who have
health insurance, not on the estimated 45 million who don't. If the
federal government stopped encouraging people with health insurance to
be less careful consumers, then coverage would be more affordable, the
number of people without coverage would shrink, and the quality of care
would improve.

My family just switched to a high deductible policy, and its amazing how much our behavior has changed.  We question doctors now -- do we really need that?  We had to take my son in for a CT scan on his head (he got hit by a line drive at the hot corner the other day) and we actually asked the price before we scheduled an appointment.  When was the last time you asked the price of any medical procedure or visit?

PS- The son is fine, but half his face looks like its been inflated with a high-pressure pump.


  1. Dan:

    It's interesting that people feel that they have an inalienable right to full medical coverage, to heck with costs. There are all sorts of things that poor people can't afford that would improve their life expectancy - safer cars, the ability to move out of dangerous neighborhoods, healthier food (though I'm sure anyone in this country could eat nourishing food if they cared to). But when it comes to health care, why, that would just be unfair if richer people could afford more! I don't get it.

    That said, I doubt the situation is even as bleak as I described above. How many "poor" people don't have microwaves or color TVs (often complete with cable) and many things most of us would consider luxury items? What passes for poverty in this country would be the envy of kings one hundred years ago.

  2. markm:

    Dan, I think the "reasoning" goes like this: health care protects your life, so it is a fundamental "right", unlike things that just make life better.

    Where that is wrong:

    1) Your living conditions have more influence over your health and longevity than even the best health care does. For example, childhood asthma very strongly correlates to poverty and bad neighborhoods, indicating that something in the poor neighborhoods (cockroach dandruff? stress?) causes most of the cases. Would you rather have free treatment for asthma or to not have asthma?

    Then there's obesity, which for the first time in history is a disease of the so-called "poor" rather than the rich. This means that more food than you need is within nearly everyone's reach, and I can cook good nutritious dinners from amazingly cheap bulk staples and feed a family well for less than the welfare department allows. However, a single parent or two parents both working a minimum wage job likely arrive home too exhausted to cook a good meal, so it's the cheapest possible pre-made dinners and snack foods. Better off Americans may or may not have the same shortage of time and energy, but they can buy better pre-made dinners. In addition, they can probably safely send their kids out to play, and get more exercise themselves, while a family forced by poverty to live where drug dealers rule the streets stays on the living room couch...

    Divert too much money to medical care, and you force more people to raise their children in such conditions, creating medical problems that no health care can cure.

    2) There is no "right" that can only be met by violating someone else's rights.

  3. James B.:

    I would also add that the 45 million figure for uninsured is misleading. That number refers to the number of people who lacked insurance at any point during the calendar year. The number of people who lacked insurance for the entire year is closer to 32 million. If you don't count illegal aliens, (I'm very pro-immigration, but I don't think providing universal health insurance/coverage to illegals is very smart politically or economically ) the number drops into the 20 millions. Knock out children who already eligible for CHiP programs but are participating and the number drops further. (Not that I am an advocate for CHiP but it seems silly to use these kids as evidence that we need Socialized medicine when they don't take advantage of the currently available programs.)

    Then there are people like me in the 90s. I was young and healthy and made the decision to forgo health insurance and used the money I save on premiums for when I need to see the doctor. (Now I have a HDHP like the Coyote) Of course this is a gamble. I read in the WSJ a while ago about a guy making $80,000 who eschewed health insurance and then had a heart attack.

    My point? In addition to agreeing completely with the Coyote about incentives and high-deductible planes, the debate is being driven my numbers that make the problem seem much worse that it actually is.