[December 30, 2007 @ 8:33 pm] David Catron

Japan has a “universal” health care system not unlike that which many faux-progressives advocate for the U.S.  Like all government-controlled systems, it boasts a strict price control mechanism that produces provider shortages. As AP reports, such shortages can have tragic results for patients is dire need of care:

An 89-year-old woman died after an ambulance crew spent two hours trying 30 hospitals before finding one that would accept her for treatment, Japanese officials said Friday.

The two hours the ambulance crew spent searching for an open bed should have been spent saving the patient’s life. This episode is reminiscent of this Canadian horror story, in which it took the patient two days to find a hospital to extract his appendix. 

The next time you hear someone promoting “universal” health care, imagine your mother or brother going through what these people endured.

[December 22, 2007 @ 8:45 pm] David Catron

Anxious to retain her image as America’s preeminent health care crusader, Hillary Clinton has stepped up her phony attacks on ”big insurance.” The Chicago Sun Times provides this quote:

“We’re going to tell the insurance companies that they’re going to have to change the way they do business,” Clinton said. “You know, we regulate banks. We regulate utilities. Well, we’re going to regulate the insurance companies.”

The only problem with this pose is that Mrs. Clinton continues to be a top recipient of campaign contributions from the insurance industry. In fact, only one Senator has received more money from that august fraternity than Her Majesty.

Why? Because Hillary has made a Faustian bargain with them. In order to prevent “Harry and Louise” from derailing her presidential run, she has designed her health care “reform” plan so that the insurance industry has a prominent a seat at the table.

This feature of the plan has not been well received by hard core advocates of government-run health care.  Prominent single-payer advocate Rose Ann DeMoro to describes Hillary’s plan as follows:

A proposal that will generate hundreds of millions of dollars in additional profits for the insurance giants. It’s probably not a coincidence that she is also the top recipient of healthcare sector contributions to her presidential campaign.

In other words, Hillary wants to be President so badly that she has sold out to the infamous greedheads of the “health care industrial complex.” Thus, her crusade against the insurance industry is just another Clinton fraud.

[December 19, 2007 @ 7:56 pm] David Catron

Harvard economist Greg Mankiw offers some useful observations on the zealotry with which ”progressive”  health care wonks push insurance mandates:

Some analysts, when discussing health reform plans, make a big deal over the issue of insurance mandates. They suggest that it is crucial to have mandates to solve the adverse selection problem and that plans without mandates will not work.

But Mankiw, like Barack Obama, is not convinced that mandate proponents are prepared to impose the kind of penalties required to make a mandate stick:

A mandate is only as effective as the penalty backing it up. No one, as far as I know, is ready to make failure to be insured a criminal act punishable by jail time. Instead, if a person fails to follow the mandate, he merely pays a penalty.

Thus, the the kind of mandate favored by Hillary Clinton, John Edwards, et al isn’t really a mandate at all:

The mandate is really just a financial incentive to have insurance … The only real issue is the size of the incentive.

Mankiw goes on to point out that a $1,000 fine for not having insurance is no different than a $1,000 tax credit for having coverage:

The difference is purely semantic. In both cases, a person faces $1000 incentive to have health insurance … It does not matter whether we describe that incentive as a carrot [the tax credit] or a stick [the fine].

It is instructive to note which politicians emphasize the carrot and which emphasize the stick

[December 15, 2007 @ 7:26 pm] David Catron

Jason Shafrin at Healthcare Economist links to a study that attempts to quantify the relationship between drug importation and pharmaceutical innovation. The study’s author, Frank R. Lichtenberg, concludes that importation would bring about short term price reductions but that innovation would suffer:

In the long run, a 10% decline in drug prices would … be likely to cause at least a 5-6% decline in pharmaceutical innovation.

Shafrin is dubious about the use of market size as a proxy “for what will happen if pharmaceutical trade barriers are destroyed,” but Lichtenberg’s conclusions are consistent with those of other analysts and common sense. If the potential ROI associated with new drugs declines, there will obviously be less incentive for “Big Pharma” to invest in R&D.

Ironically, Shafrin seems perfectly comfortable with Lichenberg’s least defensible claim-that drug importation will reduce domestic pharamceutical prices. This conflicts with the assessment of the CBO, which offers the following on the subject:

On the basis of its evaluation of recent proposals, the Congressional Budget Office (CBO) has concluded that the reduction in drug spending from importation would be small.

So, Lichtenberg and common sense suggest that drug importation would stifle innovation, while the CBO tells us that it wouldn’t save us much money. I wish someone would point this out to John McCain, Ron Paul, and the other politicians who promote this bad idea.

[December 11, 2007 @ 6:36 pm] David Catron

Did you think you were safe from the whims of CMS apparatchiks simply because you’re not a geezer yet? Think again.

Because Medicare bureaucrats have, in their infinite wisdom, decreed a reimbursement rate that barely covers half the cost of certain cancer drugs, many private patients will probably be denied life-saving treatment:

New Medicare rules for this class of radioimmunotherapy cancer drugs may bar thousands of lymphoma patients from receiving the treatment.

How does this affect private patients?

Federal law mandates that a hospital which doesn’t offer a drug to Medicare patients cannot offer it to patients with private insurance either.

Thus, since hospitals can’t afford to take a 50% loss on each Medicare patient receiving the treatment, they are effectively barred from offering it to anyone.

So, you could be a 40-year-old with gold-plated private insurance and still be subject to a death sentence handed down by some faceless Medicare bureaucrat.

This is government health care.  Think about it.

[December 6, 2007 @ 6:12 am] David Catron

Many advocates of government-run health care believe the SCHIP expansion debate augurs well for their cause. These folks are kidding themselves. I expand on this in the American Spectator.

[December 6, 2007 @ 6:10 am] David Catron

In addition to encroaching on individual freedom and increasing unemployment, health insurance mandates simply do not work. Among those who have pointed that out is Robert Reich. In a piece decrying Hillary Clinton’s attacks on Barack Obama, he writes the following:

We know from experience with mandated auto insurance-and we’re learning from what’s happening in Massachusetts where health insurance is now being mandated-that mandates still leave out a lot of people at the lower end who can’t afford to insure themselves even when they’re required to do so.

But why, precisely, don’t mandates work? Arnold Kling offers a succinct explanation in TCS Daily:

The reason that mandates do not work is that politicians are under too much pressure to “gold-plate” the required insurance policy. Organized lobbies and provider associations work the political process to force insurance to cover fertility treatments or eye care or other service, rather tha let individual families pick packages based on cost and need.

Several presidential candidates and a variety of misguided policy wonks are pushing insurance mandates, but we should just say “no.”

[December 4, 2007 @ 2:19 pm] David Catron

Unlike John Edwards and Hillary Clinton, John McCain understands that health insurance mandates are a bad idea. Yesterday, during a campaign stop in New Hampshire, he said mandating health insurance makes about as much sense as requiring everyone to buy a house:

I’m not going to mandate that every American have health insurance. I’m not going to mandate that every American have a home. I’m not going to mandate that every American have a college education … but I’m going to make them all affordable and available.

One can be forgiven for doubting that he can actually make all of these things “affordable and available,” but at least the man doesn’t endorse the panacea of health insurance mandates. This, along with his position on malpractice reform, makes him one of the few presidential candidates whose health care proposals don’t scare me.

[December 2, 2007 @ 2:04 am] David Catron

I have a rule of thumb that has served me well in assessing public figures: Anyone Paul Krugman dislikes can’t be all bad. Thus, Krugman’s recent attacks on Barack Obama suggest that the Illinois Senator has hidden virtues. Yesterday’s hit piece accuses Obama of infecting the Democrat debate with that most vile of all contagions-conservative rhetoric:

He’s doing the same thing in the health care debate he did when claiming Social Security faces a “crisis” … echoing right-wing talking points.

And what blasphemies has Obama uttered? He has (gasp) endorsed individual choice in the purchase of health insurance.

He doesn’t want the government to “force” people to have insurance, to “penalize” people who don’t participate.

My God! Is there no limit to Obama’s depravity? Here’s what Krugman finds most “troubling”:

Obama accuses [Clinton and Edwards] of not explaining how they would enforce mandates, and suggests the mandate would require some kind of nasty punitive enforcement.

Krugman insinuates that this is lowest sort of political rhetoric, but John Edwards has shown Obama’s concerns to be entirely valid. Edwards has just proposed a plan to garnish the wages of people who fail to buy health insurance.

So, while I’m no great fan of Barack Obama, I’m warming to him. Krugman’s disapproval, being a reverse indicator of value, has shown the Senator to be a better man than I had supposed him to be.