There’s waste in health care!
Too much cancer screening, too many heart tests, too many cesarean sections. A spate of recent reports suggest that too many Americans—maybe even President Barack Obama—are being overtreated.
Is it doctors practicing defensive medicine? Or are patients so accustomed to a culture of medical technology that they insist on extensive tests and treatments?
A combination of both is at work, but now new evidence and guidelines are recommending a step back and more thorough doctor-patient conversations about risks and benefits.
Defensive medicine, which is a response to so many frivolous lawsuits, is no doubt part of it. But the problems are deeper and systemic.
The third-party payer system is the biggest contributor. When patients are insulated from the costs of treatments, they have less incentive to ensure their necessity. Overconsumption is guaranteed under such a setup.
Some will use this and put forth the wrong solution. “We need greater government involvement,” they’ll say, “to set guidelines and provide information on what treatments are really needed.” This approach is destined to fail. Government processes are necessarily political, and any attempt by government to create such guidelines will only encourage the stakeholders – manufacturers of medical equipment, drug companies and doctors – to spend more time lobbying government to ensure the guidelines benefit them. Who will lobby for patients?
The better solution is to bring the patient back into the equation. Phase out the third-party payer system by reforming Medicare, eliminating tax distortions that give employer provided insurance an advantage of individual coverage, and remove the onerous regulations that prevent more innovative care models from emerging.
We also have to realize that there will always be a certain percentage of treatments that are not strictly necessary. It is the nature of the industry that it’s not always clear what works and what does not. The important thing is to have a system where each agent – patient, doctor and insurance – has appropriate incentive to examine the suitability of both the quality and quantity of care provided.
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First, the law:
In Louisiana, you don’t need a license to peddle pets, paintings or cars — but sell no flowers.
A 7-decades-old state law requires florists to pass a test and get a license to arrange and sell flowers, making Louisiana the only state in the USA with such a requirement. Supporters of the law say it ensures florists know what they’re doing and deliver quality products.
You know what really ensures that florists know what they doing? Customers. Asking government to enforce competence is like asking an alcoholic to enforce sobriety.
The Institute for Justice is challenging the requirement:
A lawsuit filed in U.S. District Court here last week is challenging the law’s constitutionality, claiming it infringes on a resident’s right to earn a living. The suit, filed by the Institute of Justice, a libertarian non-profit law firm based in Washington, D.C., lists as plaintiffs four local florists who have either failed the test or refuse to take it.
…Attorneys hope the lawsuit reaches the Supreme Court, said Tim Keller, lead counsel in the case.
…Keller is with the Institute for Justice, which has taken the case pro bono. The licensing law “is blooming nonsense,” the institute says on its website.
“This case is about more than just licensing florists,” he said. “It can set a precedent that restores economic liberty to its rightful place as a fundamental American right.”
That would be something to see. It’s been a long time since economic liberty has mattered in the U.S.
Licensing laws are contrary to everything America stands for. The idea that someone first needs government permission before offering a voluntary service is as contemptible as it is tyrannical.
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On the one hand, it’s a bit of validation to see well-known commentators draw attention to the same issues I have. On the other hand, it can be deflating when that commentary is so much better.
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A lot of phrases are being thrown about in the midst of the current health care debate. Perhaps the most common is the sentiment that we need to control the costs of health care.
Both right and left agree that it is desirable to have health care cost less. But controlling costs? That implies centralized authority, that someone will wrangle greedy health providers and force them to lower costs. It’s a decidedly statist vision. Yet even those offering free market solutions often adopt such language. This is a mistake. While it might seem acceptable in the proper context to say that “competition would control costs,” it subtly cedes moral ground to the statists.
Such totalitarian language is common in America. It’s routinely asserted that our presidents are elected to rule the country or manage the economy. Both of these assertions are absurd, or ought to be, if taken literally.
There are probably many other great examples. What other totalitarian terms or phrases have infiltrated and proliferated throughout our vernacular?
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Stories like this always get me mad:
…It’s called a swipe fee or interchange fee, and businesses are forced to add it to the purchase price. “This all adds up. … This is a lot of money that we are having to pay,” Lipert said.
…Some merchants’ groups and businesses have found allies on Capitol Hill to fight the fees. The National Association of Convenience Stores and 7-Eleven each sponsored a petition drive among customers, urging Congress to take action to give them some relief.
“The merchants are getting ripped off, it’s that simple. There’s monopoly power with Visa, MasterCard. They have over 70 percent of the transactions,” said Rep. Peter Welch, D-Vermont, who is pushing for congressional action on the issue.
Bull. Businesses are not ‘forced’ to do anything. They choose to accept the cards because the benefits (attracting customers) outweigh the costs. Period.
I often consider prices at these shoddy ‘mom and pop’ stores to be excessively high, but you don’t see me running to Congress to grab the gun of law to hold to their head and force price controls on them. I can choose to shop at other stores, and they can choose not to accept credit cards. That’s called freedom.
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Reason.tv gives us net neutrality for dummies:
Net neutrality: A solution looking for a problem.
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In a post on Big Government I covered the latest Index of Economic Freedom released by the Heritage Foundation and the Wall Street Journal. The results are not surprising.
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More unintended consequences from government interventionism in the market, via WaPo:
…In a matter of months, the Biomass Crop Assistance Program — a small provision tucked into the 2008 farm bill — has mushroomed into a half-a-billion dollar subsidy that is funneling taxpayer dollars to sawmills and lumber wholesalers, encouraging them to sell their waste to be converted into high-tech biofuels. In doing so, it is shutting off the supply of cheap timber byproducts to the nation’s composite wood manufacturers, who make panels for home entertainment centers and kitchen cabinets.While it remains unclear whether Congress or the Obama administration will push to revamp the program, even some businesses that should benefit from the subsidy are beginning to question its value.
“It’s not right. It’s not serving any purpose,” said Bob Jordan, president of Jordan Lumber & Supply in North Carolina, even while noting that he might be able to get twice as much money for his mill’s sawdust and shavings under the program.
“The best thing they could do is forget about it. All it’s doing is driving the price of wood up.”
…
Subsidies, by their very nature, distort markets. While this specific outcome may or may have not been foreseeable, that there would have been some destruction by forcing a good to be used for a different purpose than the market generally allocates it should have been obvious.
But don’t count on government deciding to “forget about it,” despite the damaging evidence. The deep-seated desire of some to save civilization by promoting “green technology” is based on a near-religious fanaticism in support of AGW. If it hasn’t been shaken by ClimateGate and today’s global cooling, a little economics isn’t going to do it either. The only hope is to vote them all out.
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My latest article on Big Government looks at this, and more.
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The latest assault on the western lifestyle by the loony green fringe finds our soft toilet paper in the cross-hairs:
The issue over tissue in the bathroom — the really super-soft stuff — is more like the fight about the big SUVs loved by many Americans.
Anti-green, according to environmentalists. Politically incorrect. Why should Americans use luxurious toilet paper made from old-growth trees when much of the world gets by with a far more basic and often recycled product?
Americans use luxurious toilet paper because America has long promoted a system of liberty and free enterprise that has made us much more prosperous than the rest of the world. Rest assured, if they could afford better, they’d be using better.
These nutbags won’t be satisfied until we’re living in the stone age again.
Hat-tip: John Stossel’s Take
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I am a libertarian-conservative blogger living in the DC area. I have a Master's degree in Political Science, but please don't hold that against me.
