Eliminating the Reference Points

I really wanted to make a serious point about TJIC's post on Medicare overpaying for medical devices.  However, that may be nearly impossible because the post selects "penis pumps" as the example medical device, and it is difficult to have a meaningful political dialog over penis pumps:

amount Medicare spent last year on penis pumps so that old can could stand at attention: $21 million

average price/ pump Medicare paid: $450

cost of the identical pump online: $108

Well, I will try anyway.  I am sure if someone pointed this out in the Democratic debate as a potential issue with letting the government, famed for buying $800 hammers, run our health care system, they would all have stated piously that such things would not happen under their plan.  But how?  I mean, this kind of government waste has been going on for time immemorial.  It is so closely tied to the unchangeable incentives of government managers that it could rightly be called a feature of rather than a bug in the system.

But I think I have figured it out.  This is why most socialized health care systems do not allow one to go out of system to get private care.  By banning all private care, the government eliminates all those irritating private analogs that might demonstrate they are inefficient.  So, in the example above, the government typically tackles the problem not by reducing the $450 paid by Medicare, but banning the private sales of such devices so no annoying snoop can uncover the fact that a private system could have delivered it for 1/4 the price.  Genius!


  1. Andy:

    Spot on, drumroll please.

    I heard today on the news that an European country (didn't catch who) is planning to ban homeschooling. Rationale is precisely as noted above -- Big Brother knows best.

  2. Bobby Dias:

    To me, the point is not of the person seeking medical care being able to go "outside" the system(any private doctor can be referred to)- more private doctors should be paid enough to come into the system to be the primary care doctors. Considering my primary physician is excellent, I have heard other primary physicians are not;and, worse, they are part of businesses that do the referral work which leads to much sub-standard medical care. Western Dental in California is a good example- the employees are cheap labor from India that have the technical knowledge and skills of a backward nation(for the most part).
    All their dental services are exclusive- the patient has no other choice because there are no referrals to outside dental care providers. MediCal clients are screwed.

  3. Daublin:

    Even when alternative routes are available, the apologists will say those devices are not safe, because they have not been certified by the government.

  4. Jim Collins:

    If you want to cut the costs of health care, make Government programs and insurance companies pay a fair rate for medical services and supplies. Read a doctor's bill some time to see what I'm talking about. My Mother is on Medicare and I have read some of her bills. One Doctor was paid $35 for a visit that he billed at $75. Medicare and insurance companies only pay a certain percentage of what is billed, as a result the bill is inflated so that the paid percentage is enough to cover costs. Now if someone who doesn't have insurance goes to get the same service or supplies they are billed at the inflated rate or else the Doctor or supplier are charged with fraud.