Monday, March 01, 2010

Back in the Old Days When the "Single Payer" Was the Patient, There Was "Self-Rationing"

"What is the biggest complaint about the current medical care situation? "It costs too much." Yet one looks in vain for anything in the pending legislation that will lower those costs. One of the biggest reasons for higher medical costs is that somebody else is paying those costs, whether an insurance company or the government (see chart above). What is the politicians' answer? To have more costs paid by insurance companies and the government.

Back when the "single payer" was the patient, people were more selective in what they spent their own money on. You went to a doctor when you had a broken leg but not necessarily every time you had the sniffles or a skin rash. But when someone else is paying, that is when medical care gets over-used — and bureaucratic rationing is then imposed, to replace self-rationing.

Virtually everything that is proposed by those who are talking about bringing down the costs of medical care will in fact raise those costs. Mandates on insurance companies? Why are insurance companies not already doing those things that new mandates would require? Because those things raise costs by an amount that people are unwilling to pay to get those benefits.

If not, it would be a slam dunk for the insurance companies to add those benefits to the policies and raise the premiums to cover them. What politicians want to do is look good by imposing mandates, and then let the insurance companies look bad by raising the premiums to cover the additional costs. It is a great political game, but it does nothing to lower medical costs."


~Thomas Sowell

9 Comments:

At 3/02/2010 12:16 AM, Anonymous Anonymous said...

How do we really know it costs to much? It's not like there are price tags on any of the services.

 
At 3/02/2010 12:31 AM, Anonymous Anonymous said...

Pffftt... way to stick up for those insurance companies. We wouldn't know from yearly increases in premiums and out-of-pocket expenses. Only the eighty-sixth most profitable industry? Well, immorality is still immorality: I'm sure Blackwater's profit margins are even lower.

Yeah, implement the patient as the single payer at a critical time, when he/she need a quadruple bypass, and there will be self-rationing.

 
At 3/02/2010 12:50 AM, Anonymous Anonymous said...

Anon 12:31am:

I don't think Sowell is sticking up for the insurance companies. I think he is sticking up for paying for things yourself.

Any rate, you sound like the typical ad hominem attack artist I see so much on blogs lately, so I'll ignore you.

 
At 3/02/2010 2:36 AM, Anonymous Anonymous said...

Now, post the Mortality tables for the same time period.

 
At 3/02/2010 5:13 AM, Anonymous Mikka said...

Rufus:

how would that help? It is obvious that we have FAR better medicine than we had in 60´s, 70´s, 80´s...

so even if it shows, that mortality rate was higher (which I believe it was) it wont prove that it is because of "someone else pays for that" policy...

 
At 3/02/2010 6:52 AM, Blogger W.E. Heasley said...

“Anonymous said...

Anon 12:31am:

I don't think Sowell is sticking up for the insurance companies. I think he is sticking up for paying for things yourself.

Any rate, you sound like the typical ad hominem attack artist I see so much on blogs lately, so I'll ignore you.”

Excellent point. Anon at 12:31am doesn’t address the third party payer effect, merely changes the subject to those evil insurance companies.

Anon at 12:31am then states:

“Yeah, implement the patient as the single payer at a critical time, when he/she need a quadruple bypass, and there will be self-rationing.”

That argument is ridiculous as the “critical time, when he/she need a quadruple bypass…” is the exact point where the insurance mechanism works and was intended to be used. Sowell is arguing over utilization is occurring at the other end of the spectrum for minor afflictions. In other words, Sowell is arguing that the insurance mechanism is intended for the catastrophic event. That the insurance mechanism’s third party payer effect distorts utilization for the everyday events like sniffles and rashes and hence the over utilization that drives up cost.

 
At 3/02/2010 11:12 AM, Anonymous Anonymous said...

That's what I want W E. To be able to buy the insurance I want. But the law says if I want insurance, I have to buy coverage for pap smears and mental health coverage (My pet might die and might need 13 weeks of talk with a paid professional)and on and on.

The left likes to compare auto insurance to health insurance.

When I call my auto insurance company, I get offered a buffet of options.

When I call my health insurance company, I'm told what I want is illegal.

 
At 3/02/2010 4:39 PM, Blogger juandos said...

"How do we really know it costs to much?"...

Why not ask?

"We wouldn't know from yearly increases in premiums and out-of-pocket expenses"...

Funny how you never considered the possibility that government interference in the medical services market place might in part be driving up the price, why is that?

 
At 3/02/2010 9:45 PM, Anonymous Anonymous said...

I was asking a rhetorical question with a dash of sarcasm on the side.

But ask who? I support the systems at a few doctor's offices in the area and talked with the medical billing people. Price is not part of medical billing systems.

 

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