Friday, March 28, 2008

U.S. Health Care -counterpoint to Krugman and Moore from Cato

If you read Paul Krugman and look at what Michael Moore has to offer concerning the relative merits of various countries health care systems (or in our case "non-system") you might begin pricing air fare offers to Croatia.

Before you pack your bags, take the time to read the analysis offered by the Cato Institutes's Michael Tanner and you might conclude things are relatively not as bad as you may conclude from Krugman's writings and the medical grass in rest of the world may be less green than depicted by Mr. Moore.

The author begins by pointing out the obvious-yes, the U.S.spends more on health care but that is not necessarily bad. If fact, some would say it is good and a sign we are an affluent country and are able to spend more on folk's health care than many less money challenged countries. His discussion on the vagaries and tricks and technical considerations in regard to using life expectancy and infant mortality will show that use of the those indicators has been misleading in some the widely quoted comparison studies in which the U.S. is relegated to implausibly low ordinal rankings. In view of his arguments, the assertion that the U.S. spends more and yet still has lower life expectancy looses credibility. Life expectancy varies significantly between certain states in this country even though both have the same "system". If one takes into account homicides and fatal car crashes ( areas where the U.S. unfortunately does lead the pack) the U.S. life expectancy is close to the top of the list.

If there is one simple message from Tanner's article ( there are actually a number) it is there is no free lunch. The medical utopia of which Moore talks about doesn't exist anywhere. Many countries are finding that some system of co-payments and deductibles need to be in place to mitigate the escalating costs that are occurring everywhere-rising costs are not unique to the U.S. Many are shifting to some degree of market mechanism cost control (aka- another form of rationing) while in this country the major rhetorical thrusts seem to advocate the opposite ( universal mandatory coverage and government boards to determine what is necessary care).

2 comments:

drsam said...

Good post.

There is indeed no free lunch!

I've been doing a series of posts dealing with my ideas on health care reform on my blog.

I don't think I used the phrase "No Free Lunch" in any of them, but I wish I had.

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