Maybe I'm just seeing a lot of health care-related news lately. Or maybe there really is a lot of health care-related news lately. For one thing, several presidential candidates are talking about health care, so we know it's likely to be a big issue in the '08 election.
But who pays and how? Health care always has a cost. It just depends on whose pocket is picked to pay for it.
Wisconsin Governor Jim Doyle has proposed the Healthy Wisconsin initiative which would create a statewide catastrophic reinsurance program. And while the Wall Street Journal hated the idea, John Stossel thinks it's an excellent idea...as an object lesson for the nation.
Wisconsin's Capital Times reports that "two-thirds of Wisconsin residents support the Democratic plan -- even when presented with opponents' arguments that it would be a 'job killer' that could lead to higher taxes ... Said Sen. Jon Erpenbach, D-Middleton, one of the plan's sponsors, 'Everything we have heard [against the plan], we put in the poll. And it still comes back at 67 percent approval.'"
That's why America needs "Healthy Wisconsin." The fall of the Soviet Union deprived us of the biggest example of how socialism works. We need laboratories of failure to demonstrate what socialism is like. All we have now is Cuba, Venezuela, North Korea, the U.S. Post Office, and state motor-vehicle departments.
Personally, I think if the citizens of Wisconsin want this plan, then I have no right to deny it to them.
The one argument that gets made frequently about socialized medicine is that all should participate. That way everybody pays and nobody pays too much. But a lot of people--young people--don't think they will get sick, so they don't buy insurance. And don't just take my word for it. This Reuters story says the same thing.
Adults aged 19 to 29 are the biggest group of the newly uninsured, according to an independent research group's report released on Wednesday
That age group made up 30 percent of the 45 million Americans without health insurance in 2005, according to the nonpartisan Commonwealth Fund.
Young adults, many who are just entering the workforce and can't afford the high cost of individual insurance, are the big drivers of an increase in uninsured adults, the report said...
U.S. Census and other data cited by the report show 40 percent of the uninsured young are in households earning less than the federal poverty level.
That 40% figure looks bad. Except the story doesn't include the fact that these are the years when young adults go to college. So, while their income isn't always much, their expenses are even less. There's a big difference between a college student who waits tables on weekends for pizza and beer money and a single mom of 4 kids. But these stories about how many people are uninsured never account for why so many people don't have health insurance.
Young people can almost always afford health insurance. But they don't buy it. Why? Because they don't think anything serious will ever happen to them. And whatever does happen, they can just run down to the local CareNow and get it taken care of for 50 bucks.
But government insurance programs need young, healthy people to participate, too. Why? Because they have to help pay for the cholesterol medication, heart medicines, surgeries, treatments, and therapies of their parents and grandparents. But programs like Healthy Wisconsin don't advertise this part of the plan. Usually, they emphasize that health care costs will go down because of preventive care.
Socialized medicine supporters like the idea of preventive care. They think if smoking cessation treatments and mammograms are free, then health care costs will go down. But the New York Times has a story saying this isn't actually the case.
Jay Bhattacharya, a doctor and economist at Stanford’s School of Medicine, estimates that to prevent one new case of diabetes, an antiobesity program must treat five people — "not cheaply," he says. Along the same lines, Mr. Gruber found that when retirees in California began visiting their doctor less often and filling fewer prescriptions, overall medical spending fell. People did get sick more often, but treating their illnesses was still less costly than widespread basic care — in the form of doctors visits and drugs. Louise Russell, an economist at Rutgers, points out that programs that focus on at-risk patients cost the least, but even they are rarely free.
As Dr. Mark R. Chassin, a former New York state health commissioner, says, preventive care "reduces costs, yes, for the individual who didn’t get sick."
"But that savings is overwhelmed by the cost of continuously treating everybody else."
The actual savings are also not as large as might at first seem. Even if you don’t develop diabetes, your lifetime medical costs won’t drop to zero. You might live longer and better and yet still ultimately run up almost as big a lifetime medical bill, because you’ll eventually have other problems. That would be an undeniably better outcome, but it wouldn’t produce a financial windfall for society.
There's always a cost to medicine. The fact that we expect more care for less money creates the demand for cheaper services. How do we balance this desire for low costs versus the demand for expensive care?
|