Comments on: Who should decide whether additional medical care is worth the cost? http://keithhennessey.com/2009/08/28/who-should-decide-part-1/ Your guide to American economic policy Sat, 13 Mar 2010 05:03:00 -0500 http://wordpress.org/?v=abc hourly 1 By: Lefthem http://keithhennessey.com/2009/08/28/who-should-decide-part-1/comment-page-1/#comment-11854 Lefthem Wed, 09 Sep 2009 22:30:40 +0000 http://keithhennessey.com/2009/08/28/who-should-decide-whether-additional-medical-care-is-worth-the-cost/#comment-11854 Great post. Too much is trivialized on all sides. I think one of our issues as a country is that our economic policies don't track our social mores. For example, we would consider it morally wrong for a doctor to turn away someone in need at the ER, leaving them to die on the sidewalk, but have no economic provisions for handling this. <div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('11854','Lefthem'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('11854','Lefthem','Great post. Too much is trivialized on all sides. I think one of our issues as a country is that our economic policies don't track our social mores. For example, we would consider it morally wrong for a doctor to turn away someone in need at the ER, leaving them to die on the sidewalk, but have no economic provisions for handling this. '); return false;">Quote</a></div> Great post. Too much is trivialized on all sides. I think one of our issues as a country is that our economic policies don't track our social mores. For example, we would consider it morally wrong for a doctor to turn away someone in need at the ER, leaving them to die on the sidewalk, but have no economic provisions for handling this.
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]]> By: Lefthem http://keithhennessey.com/2009/08/28/who-should-decide-part-1/comment-page-1/#comment-11852 Lefthem Wed, 09 Sep 2009 22:29:10 +0000 http://keithhennessey.com/2009/08/28/who-should-decide-whether-additional-medical-care-is-worth-the-cost/#comment-11852 Now, I don't know if you would call France, single-payer, but my friend in France who has cancer was prescient enough to purchase gold-plated private insurance, which interestingly @ $300/mo for her family pays 100% of costs and her income while she's not working. There was an article in the NY Times two sundays ago from an ex-pat American in the UK talking about the NHS no being so but, but that she was happy they also had private insurance when her husband got very sick. So I don't understand why having universal care or single-payer automatically means not having better access for those who wish to pay more. Wouldn't this govt provided health care be analogous to the public school system? <div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('11852','Lefthem'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('11852','Lefthem','Now, I don't know if you would call France, single-payer, but my friend in France who has cancer was prescient enough to purchase gold-plated private insurance, which interestingly @ $300\/mo for her family pays 100% of costs and her income while she's not working. There was an article in the NY Times two sundays ago from an ex-pat American in the UK talking about the NHS no being so but, but that she was happy they also had private insurance when her husband got very sick. \n \nSo I don't understand why having universal care or single-payer automatically means not having better access for those who wish to pay more. Wouldn't this govt provided health care be analogous to the public school system? '); return false;">Quote</a></div> Now, I don't know if you would call France, single-payer, but my friend in France who has cancer was prescient enough to purchase gold-plated private insurance, which interestingly @ $300/mo for her family pays 100% of costs and her income while she's not working. There was an article in the NY Times two sundays ago from an ex-pat American in the UK talking about the NHS no being so but, but that she was happy they also had private insurance when her husband got very sick.

So I don't understand why having universal care or single-payer automatically means not having better access for those who wish to pay more. Wouldn't this govt provided health care be analogous to the public school system?

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]]> By: Lefthem http://keithhennessey.com/2009/08/28/who-should-decide-part-1/comment-page-1/#comment-11850 Lefthem Wed, 09 Sep 2009 22:23:54 +0000 http://keithhennessey.com/2009/08/28/who-should-decide-whether-additional-medical-care-is-worth-the-cost/#comment-11850 I'm not sure I understand. Even in a single-provider system like UK (which is typically cited as the most extreme example of socialized medicine), it's possible to purchase private insurance. Same in France. In all these countries, as with everything else, the rich have more options than the poor. So why does this lessen the quality of care for a privately insured person? <div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('11850','Lefthem'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('11850','Lefthem','I'm not sure I understand. Even in a single-provider system like UK (which is typically cited as the most extreme example of socialized medicine), it's possible to purchase private insurance. Same in France. In all these countries, as with everything else, the rich have more options than the poor. So why does this lessen the quality of care for a privately insured person? '); return false;">Quote</a></div> I'm not sure I understand. Even in a single-provider system like UK (which is typically cited as the most extreme example of socialized medicine), it's possible to purchase private insurance. Same in France. In all these countries, as with everything else, the rich have more options than the poor. So why does this lessen the quality of care for a privately insured person?
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]]> By: Who Should Decide Whether Additional Medical Care is Worth the Cost? « American Elephants http://keithhennessey.com/2009/08/28/who-should-decide-part-1/comment-page-1/#comment-9757 Who Should Decide Whether Additional Medical Care is Worth the Cost? « American Elephants Tue, 01 Sep 2009 08:53:42 +0000 http://keithhennessey.com/2009/08/28/who-should-decide-whether-additional-medical-care-is-worth-the-cost/#comment-9757 [...] part one, Mr. Hennessey presents two examples of the cost-benefit analysis that show just how difficult the [...]<div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('9757','Who Should Decide Whether Additional Medical Care is Worth the Cost? « American Elephants'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('9757','Who Should Decide Whether Additional Medical Care is Worth the Cost? « American Elephants','[...] part one, Mr. Hennessey presents two examples of the cost-benefit analysis that show just how difficult the [...]'); return false;">Quote</a></div> [...] part one, Mr. Hennessey presents two examples of the cost-benefit analysis that show just how difficult the [...]
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]]> By: Who should decide whether additional medical care is worth the cost? (part 2)  |  KeithHennessey.com http://keithhennessey.com/2009/08/28/who-should-decide-part-1/comment-page-1/#comment-9530 Who should decide whether additional medical care is worth the cost? (part 2)  |  KeithHennessey.com Mon, 31 Aug 2009 17:36:12 +0000 http://keithhennessey.com/2009/08/28/who-should-decide-whether-additional-medical-care-is-worth-the-cost/#comment-9530 [...] on August 31st, 2009 by kbh in featured, health   Friday I took a step back from the legislative debate to look at two examples of hard choices in medical care.  Unlike the [...]<div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('9530','Who should decide whether additional medical care is worth the cost? (part 2)  |  KeithHennessey.com'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('9530','Who should decide whether additional medical care is worth the cost? (part 2)  |  KeithHennessey.com','[...] on August 31st, 2009 by kbh in featured, health   Friday I took a step back from the legislative debate to look at two examples of hard choices in medical care.  Unlike the [...]'); return false;">Quote</a></div> [...] on August 31st, 2009 by kbh in featured, health   Friday I took a step back from the legislative debate to look at two examples of hard choices in medical care.  Unlike the [...]
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]]> By: JoeDC http://keithhennessey.com/2009/08/28/who-should-decide-part-1/comment-page-1/#comment-9521 JoeDC Mon, 31 Aug 2009 17:18:30 +0000 http://keithhennessey.com/2009/08/28/who-should-decide-whether-additional-medical-care-is-worth-the-cost/#comment-9521 What I would like to know is why do we assume we have any idea what the benefit of the alternatives would be? In fact we have no idea. Does Skele-Gro cause cancer after 10 years. Does functioning differ after 1 year? We have very little empirical data to know any of this. Most people's doctors have no idea which works better. Device manufacturers sure as heck won't tell you and they will lobby like hell to keep you from knowing. And I guess while we are at it, how do we know how much things cost? Or are we assuming that no one ever again gets a hospital bill with $10 for an aspirin or $15 for a re-usable ice-pack. <div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('9521','JoeDC'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('9521','JoeDC','What I would like to know is why do we assume we have any idea what the benefit of the alternatives would be? In fact we have no idea. Does Skele-Gro cause cancer after 10 years. Does functioning differ after 1 year? \n \nWe have very little empirical data to know any of this. Most people's doctors have no idea which works better. Device manufacturers sure as heck won't tell you and they will lobby like hell to keep you from knowing. \n \nAnd I guess while we are at it, how do we know how much things cost? Or are we assuming that no one ever again gets a hospital bill with $10 for an aspirin or $15 for a re-usable ice-pack. '); return false;">Quote</a></div> What I would like to know is why do we assume we have any idea what the benefit of the alternatives would be? In fact we have no idea. Does Skele-Gro cause cancer after 10 years. Does functioning differ after 1 year?

We have very little empirical data to know any of this. Most people's doctors have no idea which works better. Device manufacturers sure as heck won't tell you and they will lobby like hell to keep you from knowing.

And I guess while we are at it, how do we know how much things cost? Or are we assuming that no one ever again gets a hospital bill with $10 for an aspirin or $15 for a re-usable ice-pack.

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]]> By: Joe http://keithhennessey.com/2009/08/28/who-should-decide-part-1/comment-page-1/#comment-9517 Joe Mon, 31 Aug 2009 17:13:21 +0000 http://keithhennessey.com/2009/08/28/who-should-decide-whether-additional-medical-care-is-worth-the-cost/#comment-9517 Government should enforce morality especially when it comes to sex, contraception, marriage or drugs or foul language on t-shirts, killing criminal, torturing bad guys, and deporting children of illegal immigrants. Punishing immorality is fun. Helping people out is expensive and smells like tyranny. <div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('9517','Joe'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('9517','Joe','Government should enforce morality especially when it comes to sex, contraception, marriage or drugs or foul language on t-shirts, killing criminal, torturing bad guys, and deporting children of illegal immigrants. \n \nPunishing immorality is fun. Helping people out is expensive and smells like tyranny. '); return false;">Quote</a></div> Government should enforce morality especially when it comes to sex, contraception, marriage or drugs or foul language on t-shirts, killing criminal, torturing bad guys, and deporting children of illegal immigrants.

Punishing immorality is fun. Helping people out is expensive and smells like tyranny.

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]]> By: Twitter Trackbacks for Who should decide whether additional medical care is worth the cost?  |  KeithHennessey.com [keithhennessey.com] on Topsy.com http://keithhennessey.com/2009/08/28/who-should-decide-part-1/comment-page-1/#comment-9198 Twitter Trackbacks for Who should decide whether additional medical care is worth the cost?  |  KeithHennessey.com [keithhennessey.com] on Topsy.com Sat, 29 Aug 2009 20:02:53 +0000 http://keithhennessey.com/2009/08/28/who-should-decide-whether-additional-medical-care-is-worth-the-cost/#comment-9198 [...] Who should decide whether additional medical care is worth the cost?  |  KeithHennessey.com keithhennessey.com/2009/08/28/who-should-decide-part-1 – view page – cached #RSS 2.0 KeithHennessey.com » Who should decide whether additional medical care is worth the cost? Comments Feed KeithHennessey.com What did President Bush announce today on climate change? The 2010 jobs outlook — From the page [...]<div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('9198','Twitter Trackbacks for Who should decide whether additional medical care is worth the cost?  |  KeithHennessey.com [keithhennessey.com] on Topsy.com'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('9198','Twitter Trackbacks for Who should decide whether additional medical care is worth the cost?  |  KeithHennessey.com [keithhennessey.com] on Topsy.com','[...] Who should decide whether additional medical care is worth the cost?  |  KeithHennessey.com keithhennessey.com\/2009\/08\/28\/who-should-decide-part-1 – view page – cached #RSS 2.0 KeithHennessey.com » Who should decide whether additional medical care is worth the cost? Comments Feed KeithHennessey.com What did President Bush announce today on climate change? The 2010 jobs outlook — From the page [...]'); return false;">Quote</a></div> [...] Who should decide whether additional medical care is worth the cost?  |  KeithHennessey.com keithhennessey.com/2009/08/28/who-should-decide-part-1 – view page – cached #RSS 2.0 KeithHennessey.com » Who should decide whether additional medical care is worth the cost? Comments Feed KeithHennessey.com What did President Bush announce today on climate change? The 2010 jobs outlook — From the page [...]
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]]> By: Getting Down to the Nitty-Gritty of Just What It’s All About. « American Elephants http://keithhennessey.com/2009/08/28/who-should-decide-part-1/comment-page-1/#comment-9090 Getting Down to the Nitty-Gritty of Just What It’s All About. « American Elephants Sat, 29 Aug 2009 09:02:09 +0000 http://keithhennessey.com/2009/08/28/who-should-decide-whether-additional-medical-care-is-worth-the-cost/#comment-9090 [...] additional medical care is worth the cost.” Most of the health care debate boils down to this question. Mr. Hennessey has a wonderful ability to frame questions in a way that makes you think through the [...]<div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('9090','Getting Down to the Nitty-Gritty of Just What It’s All About. « American Elephants'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('9090','Getting Down to the Nitty-Gritty of Just What It’s All About. « American Elephants','[...] additional medical care is worth the cost.” Most of the health care debate boils down to this question. Mr. Hennessey has a wonderful ability to frame questions in a way that makes you think through the [...]'); return false;">Quote</a></div> [...] additional medical care is worth the cost.” Most of the health care debate boils down to this question. Mr. Hennessey has a wonderful ability to frame questions in a way that makes you think through the [...]
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]]> By: Mark http://keithhennessey.com/2009/08/28/who-should-decide-part-1/comment-page-1/#comment-9080 Mark Sat, 29 Aug 2009 05:14:49 +0000 http://keithhennessey.com/2009/08/28/who-should-decide-whether-additional-medical-care-is-worth-the-cost/#comment-9080 In a single-payer system, where all get the same benefit, the $5M treatment could never be offered, as it would be too costly for everyone. If some were allowed (by being wealthy) to buy the $5M treatment, however, there is a chance that technology would improve, and it would eventually come down in price to a point where everyone could afford it and benefit. This is the biggest (although not only) problem I see with a single-payer system. Development of new technologies would be greatly retarded. I suspect this same mechanism operates on a large scale where new technologies are developed in the US, and eventually trickle down to single-payer countries. If the US moves to single payer, the world's most innovative medical market will slow development dramatically. Not only will this cost lives, but also hinder a source of jobs and wealth creation. <div class="comment-remix-meta"><a href="#" class="replyto" onclick="replyto('9080','Mark'); return false;">Reply</a> - <a href="#" class="quote" onclick="quote('9080','Mark','In a single-payer system, where all get the same benefit, the $5M treatment could never be offered, as it would be too costly for everyone. If some were allowed (by being wealthy) to buy the $5M treatment, however, there is a chance that technology would improve, and it would eventually come down in price to a point where everyone could afford it and benefit. \n \nThis is the biggest (although not only) problem I see with a single-payer system. Development of new technologies would be greatly retarded. I suspect this same mechanism operates on a large scale where new technologies are developed in the US, and eventually trickle down to single-payer countries. If the US moves to single payer, the world's most innovative medical market will slow development dramatically. Not only will this cost lives, but also hinder a source of jobs and wealth creation. '); return false;">Quote</a></div> In a single-payer system, where all get the same benefit, the $5M treatment could never be offered, as it would be too costly for everyone. If some were allowed (by being wealthy) to buy the $5M treatment, however, there is a chance that technology would improve, and it would eventually come down in price to a point where everyone could afford it and benefit.

This is the biggest (although not only) problem I see with a single-payer system. Development of new technologies would be greatly retarded. I suspect this same mechanism operates on a large scale where new technologies are developed in the US, and eventually trickle down to single-payer countries. If the US moves to single payer, the world's most innovative medical market will slow development dramatically. Not only will this cost lives, but also hinder a source of jobs and wealth creation.

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