As I have pointed out before, the one health care position John McCain and Barack Obama have in common is their wrong-headed support of prescription drug reimportation. It appears, however, that both candidates may be waking up:
Barack Obama and John McCain are reviewing their support for allowing individuals to import cheaper prescription drugs in light of tainted medicines and other goods made in other countries, their advisers said on Thursday.
Unfortunately, the myriad economic and safety issues that militate against reimportation have still not quite convinced them that they were just wrong on this issue:
Neither adviser said their candidate had abandoned reimportation, but had realized it would be more difficult.
One must, I suppose, make allowances for the fact that these guys are politicians. Presumably they will eventually decide to deep six this exceptionally dumb idea.
Although we can safely disregard the WSJ piece by David Cutler and Brad DeLong on Obama’s health care plan, there is an excellent article on the plan in Health Affairs, and its conclusion is not flattering:
It greatly increases the federal regulation of private insurance but does not address the core economic incentives that drive health care spending. This omission along with the very substantial short-term savings claimed raise serious questions about its fiscal sustainability.
Its ”play or pay” feature and potential for private insurance crowd-out also trouble the authors:
Heavy regulation coupled with a fallback National Health Plan and a play-or-pay financing choice also raise questions about the future of the employer insurance market.
This is a detailed, intelligent though somewhat dry piece. But if you want an honest, realistic assessment of Barack Obama’s health care plan, it’s well worth a read.
Last year, I took issue with a “study” which claimed to show that 50% of bankruptcies were caused by medical bills. At that time, I pointed out that a couple of researchers checked the data and discovered that only 17% of bankruptcies could be plausibly attributed to medical bills.
Well, it turns out that the actual number is only 5%. Researchers at UC Davis have found that reckless overspending has driven most personal bankruptcies, and that medical problems are not even the second most prevalent cause:
Zhu [the study’s author] concluded that debt accounted for more than 50 percent of recent bankruptcies, while medical problems caused just 5 percent and unemployment led to only 13 percent.
So, how did the authors of that original study reach conclusions so much at odds with those of other researchers? Well, its authors run PNHP, an advocacy group committed to foisting single-payer health care on the American public.
In other words, doctors Woolhandler and Himmelstein fudged the data in their widely publicized “study” to support their political agenda. Happily, there are still a few honest researchers out there whose work can actually be trusted.
That’s right. Progressive tut-tutting about “health care disparities” notwithstanding, it turns out that we spend almost exactly the same amount of money on health care for the poor as we do for the rich. Robert Samuelson reports the following in Newsweek:
On average, annual health spending per person—from all private and government sources—is equal for the poorest and the richest Americans. In 2003, it was $4,477 for the poorest fifth and $4,451 for the richest.
This information comes from a study conducted by economist Gary Burtless of the Brookings Institution, who was evidently not expecting such results:
Burtless was understandably astonished when he assembled these data … Probably in no other area, notes Burtless, is spending so equal—not in housing, clothes, transportation or anything.
Samuelson quotes the Burtless study to show that the health care debate often revolves around phony issues. To that end, he also points out that medical outcomes for the uninsured don’t differ significantly from those of the insured:
Outcomes differed little … After about six months, 20.4 percent of the insured and 20.9 percent of the uninsured judged themselves “better”; 32.2 percent of the insured and 35.2 percent of the uninsured rated themselves “worse.” The rest saw no change.
These data about spending and outcomes will surprise many and be denied by many others. But if we are ever going to fix health care, we will have to stop allowing everyone to bring his own “facts” to the debate.
Last week I did a brief post on Governor Palin’s effort to repeal Alaska’s burdensome and counterproductive Certificate of Need statute. I’ve done a more detailed piece on that initiative and the CON issue for the American Spectator. Here’s an excerpt:
State CON laws originated, like so many bad health care ideas, with a mandate from the federal government. In 1974, states were effectively told by Washington that no new medical facilities could be built unless a “public need” had been demonstrated. The idea was to reduce costs, but the only measurable effect of this federal decree was a morass of bureaucratic red tape that stifled competition in the health care market.
And, like so many bad government ideas, the CON monster has been difficult to kill even after Washington tried to drive a stake through its heart:
In 1987, the federal statute was finally repealed, but many states inexplicably kept their CON processes in place. Alaska was one of them and, as Governor Palin put it in an editorial for the Anchorage Daily News, “Under our present Certificate of Need process, costs and needs don’t drive health-care choices — bureaucracy does. Our system is broken and expensive.”
The rest of the article can be read here.
As I have noted before, I have a rule of thumb that has served me well in assessing public figures and policy ideas: Anyone or anything Paul Krugman dislikes can’t be all bad.
Goodman correctly points out that, like so many other terms used in today’s political and policy debates, “uninsured” has been rendered meaningless by misuse. Thus, he suggests dropping the misnomer:
Here is the idea: only people who are denied care are truly uninsured. Everyone who gets care is effectively insured by some mechanism. So instead of producing worthless statistics that people fling around in vacuous editorials and pointless debates, the Census Bureau should produce meaningful numbers, identifying all of the sources of funds people will draw on if they need medical care.
Krugman, with his trademark dishonesty, pretends not to understand what Goodman is getting at. Instead, he reduces the entire argument into one of his tired faux-progressive talking points:
Last week John Goodman, an influential figure in Republican health care circles, explained that we shouldn’t worry about the growing number of Americans without health insurance, because there’s no such thing as being uninsured. After all, you can always get treatment at an emergency room.
You would think that a guy like Krugman, who was once actually respected as an economist, could come up with some new material. But, alas, it is not to be. Instead we get “After all, you can …… zzzzzzzzzzzzz
In reality, Goodman’s post provides a pretty good blueprint for classifying “the uninsured” in a way that might actually be useful in clarifying the health care reform debate.
Not that Krugman and his fellow travelers are interested in clarity.
+ May 2009
+ May 2008
+ May 2007