What am I thinking today?

Friday, December 04, 2009

Paul Krugman's Argument for Health Care Reform

wrt Paul Krugman's Oped in NY Times, note the following:

"First, the uninsured in America are, on average, relatively young and healthy; covering them wouldn’t raise overall health care costs very much." effectively means tax the young and the healthy. That is a disincentive for being healthy (& young -- but you don't have much choice there).

How does the government create incentive for being healthy? This way: "which include efforts to improve incentives for cost-effective care, the use of medical research to guide doctors toward treatments that actually work, and more." This basically means a Govt panel will tell what should money be spent on, what tests are OK to be done etc.

I have the following issues with these aspects of this plan. Other issue is mentioned here.
  1. Fix Medicare / Medicaid first. If people don't know how to run those programs, they won't run anything else properly. (hint: this is a trick command! The whole point of this is to get you in an infinite loop!!)
  2. Don't regulate health care by panel. From experience, all it ends up is creating a black market. People in UK and Canada come to US for treatment they cannot get there. That is effectively a black market. You can always argue that people have nowhere to go now since US also has govt run healthcare (problem solved!). What will end up happening is that there will be test centers / doctors who will perform one kind of procedure / tests and bill another one! A whole new era of fraud will be unleashed.
Paul isn't asking the right questions as an economist. He is playing a politician's role. I would urge him to get in his economist role and get the following questions answered:
  1. If insurance companies are making too much profit, why doesn't the supply of insurance companies increase?
  2. If pharma companies are making too much profit, why doesn't the supply of pharma companies increase?
  3. If doctors are making too much profit, why doesn't the supply of doctors increase?
  4. If testing companies are making too much profit, why doesn't their supply increase?
  5. If health care companies have too much inefficiency in them -- too much is spent on paper work, then why is there so much paperwork? Remember, President Obama proposed a national health record system to "improve" efficiency. Why does this inefficiency exist? No company would want to spend money on inefficient activities.
High profits by various health companies and high inefficiency has been stated as a reason for high costs by Democrats. Somewhere in the answers to the above 5 questions you will find some govt interference blocking supply and increasing inefficiency. Maybe I am prejudiced. Show me an economic argument. Find the truth and form policies based on that, not the other way around.