Tag Archives: Health Care

Quick Thoughts on the Health Care Ruling

The Supreme Court upheld the health care bill, as you’ve no doubt heard by now. Over at the Daily Caller, I add a few quick thoughts about how Randy Barnett’s Commerce Clause argument also applies to Congress’ taxation power, on the Court’s reluctance to check the other branches’ excesses, and how happy rent-seeking insurance companies must be right now.

Read the whole thing here.

If Air Travel Worked Like Health Care

This video is based on article by National Journal‘s Jonathan Rauch, which you can read here. I also recommend Rauch’s excellent book Government’s End.

6 Pages of Legislation, 1,000 Pages of Regulation

HHS is about to issue over 1,000 pages of new regulations stemming from last year’s health care bill. That’s not a huge surprise, considering the bill is about 2,000 pages long.

But these regulations all come from a 6-page section covering accountable care organizations, or ACOs.

According to Politico, John Gorman, who runs a health care consulting firm, “expects a 1,000-page rule to come out on Thursday, March 31—because he doesn’t think HHS will want to deal with releasing the regulations on April Fool’s Day.”

Understanding the Health Care System

One of the worst parts of the current health care system is its sheer complexity. Because most of the payments are made by third parties, the paperwork burden is enormous. Co-pays, deductibles, ever-shifting networks, and so on. Unfortunately, that complexity is about to get a lot worse because of this year’s health care bill. Check out this flow chart of what the health care system will look like once Obamacare is implemented:

You can also download a PDF version of the chart that allows you to zoom in more closely. It’s worth taking a few minutes to look at all the agencies and bureaucracies in greater detail.

This chart was released by Rep. Kevin Brady, a partisan Republican. But whatever your politics, you should be wary of any scheme as grandiose as Obamacare. This represents a re-ordering of one sixth of the American economy.And not only is the government tasked with making this flow chart flow smoothly. It is also tasked with fighting two land wars in Asia. With delivering the mail. With developing new energy technologies. With overhauling the nation’s entire financial system. No organization can do all those things and do them well. Doesn’t matter how talented and well-meaning the people behind it are. It is beyond the limits of anyone’s ability to plan.

As Dan Mitchell points out, real health care reform would have just two parties to most transactions: buyer and seller.

There are two other things I’d like to see. One is that health insurance should not be linked to your job. Under both the current system and Obamacare, if you lose your job, you lose your insurance at exactly the time you need it most. This can be done by treating employer-provided insurance exactly the same as individual insurance in the tax code. Employer-provided insurance is currently given special treatment.

Real reform would also fundamentally change the way we use health insurance. The purpose of insurance is to insure against unexpected risks. Your annual physical does not fit that description. Having insurers pay for routine, expected expenses is like using your auto insurance to pay for a tank of gas and a car wash. No wonder premiums are so high. Health insurance isn’t really insurance. It’s pre-paying for your health care. And it also has one whopper of a principal-agent problem that explains a large portion of why health costs are so shockingly high.

Regulatory Problem, Regulatory Solution?

A dying patient in the UK’s NHS made the news after nurses refused to bring him a glass of water, despite his repeated begging. He died soon after of pneumonia. It really is a terrible story.

Had that poor soul lived in Arizona, he might not have had that problem. In that fine state, it is against the law to refuse someone a glass of water if you have any to spare.

As the U.S. slowly but surely hands its health care sector over to government, and NHS horror stories repeat themselves on this side of the Atlantic, this may become a more pressing issue than one would expect.

Four Ways to Spend Money on Health Care

As the House gets ready to pass the health care bill today, I’m reminded of one of the first lessons in economics I ever learned. Milton Friedman put it best:

There are four ways in which you can spend money. You can spend your own money on yourself. When you do that, why then you really watch out what you’re doing, and you try to get the most for your money. Then you can spend your own money on somebody else. For example, I buy a birthday present for someone. Well, then I’m not so careful about the content of the present, but I’m very careful about the cost. Then, I can spend somebody else’s money on myself. And if I spend somebody else’s money on myself, then I’m sure going to have a good lunch! Finally, I can spend somebody else’s money on somebody else. And if I spend somebody else’s money on somebody else, I’m not concerned about how much it is, and I’m not concerned about what I get. And that’s government. And that’s close to 40% of our national income.

The biggest problem with health care today is that patients only pay 12 percent of costs out of pocket.  As far as each individual is concerned, it’s basically on sale for 88 percent off! No wonder we spend so much on health care.

Today’s bill consists almost entirely of spending other peoples’ money on other people. If it becomes law, that 12 percent figure will fall even further. This is no way to keep costs under control. However noble Congress’ intentions may be, its bill will not work as advertised. Human nature won’t allow it.

How Do These People Avoid Cognitive Dissonance?

Supporters of the health care bill spend a lot of time attacking health insurance companies.

The health care bill, by the way, would legally require people to give a lot of money to those same insurance companies. A lot of money. It would be the largest corporate gift Washington has ever given out — as much as $1.5 trillion over ten years by one estimate.

Health insurers’ loudest detractors are actually their best friends, and they don’t even seem to realize it. Apparently, regulatory capture is not always a conscious process.