28 Jul 2009

Health Care Myths

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Clifford Asness, a hedge fund manager blogging at StumblingOnTruth, debunks the left’s arguments for socialized health care and has some fun doing it.

Health Care Costs are Soaring

No, they are not. The amount we spend on health care has indeed risen, in absolute terms, after inflation, and as a percentage of our incomes and GDP. That does not mean costs are soaring.

You cannot judge the “cost” of something by simply what you spend. You must also judge what you get. I’m reasonably certain the cost of 1950’s level health care has dropped in real terms over the last 60 years (and you can probably have a barber from the year 1500 bleed you for almost nothing nowadays). Of course, with 1950’s health care, lots of things will kill you that 2009 health care would prevent. Also, your quality of life, in many instances, would be far worse, but you will have a little bit more change in your pocket as the price will be lower. Want to take the deal? In fact, nobody in the US really wants 1950’s health care (or even 1990’s health care). They just want to pay 1950 prices for 2009 health care. They want the latest pills, techniques, therapies, general genius discoveries, and highly skilled labor that would make today’s health care seem like science fiction a few years ago. But alas, successful science fiction is expensive.

In the case of health care, the fact that we spend so much more on it now is largely a positive. The negative part is if some, or a lot, of that spending is wasteful. Of course, that is mostly the government’s fault and is not what advocates of government control want you to focus upon. We spend so much more on health care, even relative to other advances, mostly because it is worth so much more to us. Similarly, we spend so much more on computers, compact discs, HDTV, and those wonderful one shot espresso makers that make it like having a barista in your own home. Interestingly, we also spend a ton more on these other items now than we did in 1950 because none of these existed in 1950 (well, you could have hired a skilled Italian man to live with you and make you coffee twice a day, so I guess that existed and the price has in fact come down; my bad, analogy shot). OK, you get the point. Health care today is a combination of stuff that has existed for a while and a set of entirely new things that look like (and really are) miracles from the lens of even a few years ago. We spend more on health care because it’s better. Say it with me again, slowly – this is a good thing, not a bad thing.

By the way, I do not mean that the amount we spend on health care in this country isn’t higher than it needs to be. …

In summary, if one more person cites soaring health care costs as an indictment of the free market, when it is in fact a staggering achievement of the free market, I’m going to rupture their appendix and send them to a queue in the UK to get it fixed. Last we’ll see of them. …

Socialized Medicine Works In Some Places

…The funny part is socialized medicine has never been truly tested. Those touting socialism’s success have never seen a world without a relatively (for now) free US to make or pay for their new drugs, surgical techniques, and other medical advancements for them. When (and I hope this doesn’t happen) the US joins in the insanity of socialized medicine we will see that when you remove the brain from the body, the engine from a car, the candy from the striper, it just does not work.

So, please, stop pointing to all those “successes” that even while living off the US still kill hard-working people who could afford their own health care while they stand in line for the government’s version (people’s cancers growing while waiting ten weeks for a routine scan, which these people could often afford on their own if allowed, is a human tragedy). Even the successes you gin up for them would not be possible without the last best hope of humankind (the US) on the front lines again making the miracles for the world. …

A Public Option Can Co-Exist with a Private Option

The government does not co-exist or compete fairly with private enterprise, anywhere. It does not play well with others. The regulator cannot be a competitor at the same time. It cannot compete fairly while it owns the armed forces and courts. Finally, it cannot be a fair competitor if when the “public option” screws up (can’t pay its bills), the government implicitly or explicitly guarantees its debts. We have seen what happens in that case and don’t need a re-run.

The first thing the government does is underprice the private system. You can easily be forgiven for thinking this is a good thing. Why not, cheaper is better, right? Wrong. They will underprice private enterprise by charging less to the purchaser of health insurance, not by actually creating it cheaper. Who makes up the difference? Well, you and your family do if you pay taxes, or your kids will pay taxes, or their kids will pay taxes. The government can always underprice competition, not through the old fashioned way of doing it better, they never do that, but by robbing Peter to pay for Paul. They are taking money from your left pocket and giving you a small portion of it back in your right pocket. They do it every day before breakfast, and take a victory lap for the small portion they return.

Second, the government ultimately always cheats when it’s involved in “honest” competition. Try mailing a first class letter through Fed-Ex, or placing an off-track bet on your favorite horse with a bookie, or playing a lottery through a private company. Uh, you can’t, so please stop trying, I don’t want you to hurt yourself. Once the government discovers it cannot win, it changes the rules. You see, the government has the power to legislate, steal, imprison, and even kill. Those are advantages most private firms do not have…

Health Care is A Right

Nope, it’s not. But we are at the nuclear bomb of the discussion. The one guaranteed to get me yelled at or perhaps picketed by a mob waving signs printed up with George Soros’s money. Those advocating socialized medicine love to scream “health care is a right.” They are loud, they are scary, but they are wrong about rights…

This is more philosophy than economics, and I’m not a philosopher. But, luckily it doesn’t take a superb philosopher to understand that health care simply is not a “right” in the sense we normally use that word. Listing rights generally involves enumerating things you may do without interference (the right to free speech) or may not be done to you without your permission (illegal search and seizure, loud boy-band music in public spaces). They are protections, not gifts of material goods. Material goods and services must be taken from others, or provided by their labor, so if you believe you have an absolute right to them, and others don’t choose to provide it to you, you then have a “right” to steal from them. But what about their far more fundamental right not to be robbed?

In fact, although it’s not the primitive issue, the constant improvement in health care gives another good example of why the “right” to health care makes little sense. Did you have a right to chemotherapy in 1600 AD? You could have protested to Parliament all you wanted, but chemo just didn’t exist. Then, did you have a right to it the moment some genius invented it? You did not pay for the research. You did not make the breakthrough. Where do you get the right? How did it come into existence for you the moment somebody else created these things? I’m pretty sure you cannot have rights to material goods that don’t exist, and I am pretty certain that the moment some genius (or business, or even government) brings them into the world your “rights” do not improve. …

So why do people scream health care is a “right” if it so obviously is not? If not a right it can still be willingly provided as charity by society. But those screaming “health care is a right” worry that this will not work out as well for them. In fact it would work out if all they cared about was good health care for all, and not power, but they do love that power.

Those seeking free health care could admit these are not rights but they simply want other people’s stuff, and be honest supplicants, or open thieves. However, they believe that guilt and the false moral high ground work better for them.

Read the whole thing.

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3 Feedbacks on "Health Care Myths"

Carrie M

Excellent. Thanks for sharing this.



Dean

I think this Daily KOS entry (below) pretty much sums it up. While we can speak high platitudes about the intervention of governmental do nothings using the levers of government power to undermine the quiet workings of an efficient market in healthcare, what in fact has developed is a marketplace in which the product (health CARE) is degraded in pursuit of profit. Many market participants are truly trying to help, and profit motives will drive innovation, it cannot be denied. However, structures have developed to weed out the sick, the ones who actually are in need of the product.

We have spawned a system of infinite complexity which is out to insure the least likely to need healthcare are those most sought to fall under its protection. Others need not apply.

A governmental ‘option’ would provide for those who are otherwise underserved by this maze. You want your gold plated plan, with access to the preferred medications, treatments when you think you are in need, the current proposals certainly allow for that.

Right now, if you want to accept all the financial risk, you can do so. Pay retail rates for all procedures, walk into any doctor and write a check from your pocketbook. No middleman, no reviews, lists or preferred providers. I think there are very few willing or capable of shouldering that level of risk and responsibility. The minute you are on ANY plan, you need to read the fine print and generally it is fine for a reason.

http://www.dailykos.com/storyonly/2009/7/25/756972/-Dear-Mr.-President

Karen, why oh why did you send me this link?



JDZ

Reading those commies at Daily Kos, and agreeing with them, too! For shame, Dean.



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