In an effort to balance out my posts i have decided to use an article from New York Times. Porter (the writer) has a lot to say about the history of health care in the US. He has also come up with some compelling data to support his view of private America. Porter sees the government as the answer to the healthcare problem (last paragraph). "Our track record suggests that handing over responsibility for social goals to private enterprise is providing us with social goods of lower quality, distributed more inequitably and at a higher cost than if government delivered or paid for them directly," writes Porter. My question is then, How does the writer's view fit in the fiscal cliff discussion?
To me he is making a case for continued government intervention in the health system. From our basic understanding of economics we know that the market does not "satisfy broad social needs." But in times like these (Budget deficits and all) should government play a big role in the economy?
The term "health care system" is tooo wide and badly distorted. According to World Health Organization, the United States has the highest level of government health care spending per capital however still has one of the highest level of the mortality rate than most of the world's industrialized nation. In the 2012, the health care expenditures were stimated to be $2,8 trillion. Therefore, the US's government is far from a free market society. It is imposible to called it free market. At the same time, it is impossible to consider the health care like a common good. In crisis times, it is also imposible to keep with the paternalism government. I think the budget is not well distributed.
ReplyDeleteI also share with you a link of the topic, which criticizes the Obamacare system, specially the Free Market Healthcare Reform
(http://www.usnews.com/news/blogs/rick-newman/2012/03/28/the-folly-of-free-market-healthcare-reform)
While I may be somewhat uninformed on this topic, I'll still take a stance. I simply do not agree with Porter's thesis. He believes private enterprises' desire to turn a profit is a hindrance to our economy per se. This is untrue. I will touch on three points.
ReplyDelete1) He states that private enterprises, with their profit-seeking motives, push unnecessary care on patients. Assuming this to be true, how does he figure having government subsidies on surgeries, etc. will help or stop this in any way? It seems to me that hospitals can continue to do these same practices whether or not the government gets involved. To my mind, it is only improved competition that will allow do away with frivolous care.
2) Next, he states that "...The consequences of [profit-seeking] might not be so great for...patients." I disagree. "Profit seeking" is the main incentive for improved medical care and medicine. The alternative--mostly government-run/subsidized program such as Amtrak or USPS--show no growth or improved care in any way, shape, or form.
3) Porter states that "businesses devote almost 6 percent of the nation’s economic output to pay for health insurance for their employees." If the government were to drastically change the health care system and take it under its wing, this 6 percent of economic output businesses currently shell out will surely not instead take the form of higher pay for employees. My view does prove Porter's point of our current inequitably in health care; however, I'm not willing to agree that taking this pay away from employees will do much more good if used by the government instead.
One other point... Can anyone answer me this?--the government is spending $140 billion this year on subsidizing home ownership. Porter states this is a "benefit only 20 percent of mostly well-to-do taxpayers" will reap. Further, homes must--realistically--be viewed as a good that loses value over time. This seems irresponsible. So, how are we to believe the government's control of health care will pan out any better?
For point 2, I meant "profit seeking" as "for profit health care"; not "unnecessary care"
DeleteI agree with Priscilla, the main issue is not whether we have a public or private health care system, but the fact that we're currently saddled with a crazy expensive public/private boondoggle that seems to get the worst of both worlds. Government spending that creeps into private markets - whether through tax deductions for employer provided health care or home subsidies for the wealthy that David and Porter so rightly critique - corrupts market's normally efficient nature.
ReplyDeleteMilton Friedman wrote an editorial about health care reform in 2001 shortly before his death. In it he (unsurprisingly) proposed a sort of utopian, libertarian solution. However, he also acknowledged that compared to our mixed system, single payer systems like those in Canada and Great Britain were doing an all around better job. Even the editor of Reason magazine (an incredibly libertarian magazine) wrote that he prefers French healthcare to the American system! Maybe the libertarian system would work, but there is scant evidence that it would, whereas nationalized health care systems have been implemented successfully in developed countries around the world. Frankly, I'd prefer either over our current system. As Stephen Colbert would say, "pick a side! We're at war!"
Friedman
Reason
I have a question. It seems the French system does, in fact, work better than our mixed system. However, the French are able to implement this system, in part, because their secondary school system is nationalized as well. In the United States, students are paying around $200,000 for medical school and expect their pay later in life to make this a good investment. In France, doctors are happier with less pay because they have not made this huge capital investment in their education. Do you believe that nationalization of our healthcare would work without also changing our school system in the process?
DeleteDavid, this is an interesting point. Would nationalizing healthcare lower pay enough so that there is no longer an incentive to invest in medical school? Would the lower earnings fail to attract top-tier students, leading to a lower-caliber of medical professionals? Nationalizing the school system would certainly be one way to counter-act this disincentive, however that also requires substantial government spending. Also what programs are provided? Would you include nursing programs and management programs? I think it may be worth it to try nationalizing healthcare without changing the schooling system and see if there is a significant change in interest in the medical field.
DeleteI imagine that if we truly nationalized healthcare, nationalizing the educational component of it may be the logical next step.
DeleteI agree with David's point that until we can eliminate or drastically reduce hospital's pushing (often) unnecessary surgeries, medicine, etc. on their patients, we will have a problem with health care. I also agree that the best way to do this is to provide more competition for health care services, since I don't think there is another effective way to regulate hospital's "pushyness".
ReplyDeleteWe already tried creating competition by making healthcare a private sector and it didn't work. Do you think it will work now because of the threat of Obamacare? Is there a way for other people to get into the industry?
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