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February 15, 2007

Health Care Reform

Oh Dear.

Via Greg Mankiw I see a piece in the NY Times about the joys and glories of single payer health care systems.

Critics of the single-payer plan have long railed against the specter of socialized medicine, suggesting that it means being treated by government functionaries. Yet people who have experienced single-payer coverage firsthand seem unconcerned. When one of my sons needed surgery for a broken arm during a sabbatical in Paris, for example, the medical system we encountered was just as professional as the American one and far less bureaucratic.

One slight problem. The French health care system is not a single payer one. Heck it's not even free at the point of use. You pay for your treatment when you get it and then get 70% of it (except for cancer treatment where it is 100%) back about ten days later. If you want to be insured for the full costs, then you take out (as most do) private insurance as well.

Don't these people have editors?

February 15, 2007 in Health Care | Permalink


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Sounds strange. can't make out what the up-front payment is supposed to be for except, possibly, to afford the opportunity for review of the patient's
enrolled (or paid-up) status. Good for the employment of a bunch more paper-shufflers, though.

Also, it seems strange that folks are insuring primarily against being in the position of needing care exceeding their abilities to pay--and then are required to do just that--to pafor what they've already paid to be insured against.

The fact that, in any case, they're going to have to pay 30% by themselves again takes it out of the realm of insurance. In the case of really catastrophic need (for which most such plans are ostensibly designed), even that proportion can "break the bank" for many, whether or not they were able to scrape up the up-front full payment.

I believe insurance to be a viable method for distributing the risk of extremely adverse financial consequences. But, as a method for "health-care delivery," it's got the built-in defect of all third-party payment systems: it substitutes the economic decision-making of someone else for that of both the buyer and seller of services and introduces, additionally, greater system costs in the need for administration.

My Rx is to stay away from doctors (and, if you can manage it, don't get sick, which will help with staying away from the doctors).

Furthermore, third-party systems are discriminatory against the uncovered. The greater their ranks, the greater the club wielded against providers insofar as the height of fees is concerned and the greater the incentive to that provider to compensate what he perceives as his shortfall on the backs of the fewer uncovered. In effect, those intimidated into paying "protection" to the Mafiosi want others to kiss the same whip in the (mistaken) belief that the additional payments thus enforced will lighten their own burden. The stupid rarely learn.

Here take another dose of my Rx.

Posted by: gene berman | Feb 15, 2007 3:22:44 PM

Re Tim's final point: AIUI, opinion columns are only sub-edited for grammar & style rather than fact-checked.

Posted by: john b | Feb 16, 2007 10:52:19 AM

To be fair, the first one he mentions in the piece is Canada, not France. Any views on that that you care to share?

Tim adds: Sure, one of the few health care systems even worse than the NHS. If the govt system is providing a treatment then it's illegal to offer that treatment privately.

Posted by: Katherine | Feb 16, 2007 10:53:18 AM