The Barnard Observer
▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀▀
Home Vault Misc Contact c2003-09 Thomas Barnard
Lowering the Costs of Healthcare
Is it a struggle for control, or is it a struggle for control of costs?
It appears to me to be a struggle for control over healthcare. If it were a struggle for control of costs, I believe this could be handled through the marketplace. Although associations like the AMA certainly stand in the way of this, and so to the drug company lobbyists.
But do not construe that I stand with those folks on the right because, basically, they talk about the marketplace but at every opportunity they strive to upend the marketplace. Why else are patents so popular? Patents represent monopolies, and business basically likes monopolies. Why do investors like Microsoft and Intel? And why does European Commission keep Microsoft and Intel in their sights? Because they're monopolies.
So, really I stand apart from business people who say they like they like the marketplace but really like monopolies. But speaking of monopolies, you have those on the left who say they only way to reduce costs is by fiat, which is to say, put the whole thing under government control. My problem with that is that you are putting all your eggs in one basket. Yes, Medicare appears to be going along swimmingly, but I'm not so sure. Why, you ask? Because the bulk of people to be covered under Medicare will just be starting next year when the baby-boomers turn 65. Because it is not financially stable. When the rolls start filling up, the government coffers will be under tremendous pressure to: 1) either move the age up, or 2) raise taxes.
In Britain, I think it was the The Economist which expressed concern about the national health care system in the UK once the North Sea oil dries up, because no matter how you look at the numbers, North Sea oil has supported national health all these years. It was Margaret Thatcher who once said about social programs, "The problem is: eventually you run out of other people's money."
In the U.S., we have Obama. Obama is a yuppie socialist. His father was a socialist. And we have just been through a father and son thing with Bush. It seems obvious to me that Bush junior was determined to right a wrong when he took over Iraq as his father should have.
If it is a struggle of control of costs...
If it is a struggle of control of costs, then I think Obama could still succeed very well indeed if he could do the following:
1) Increase the supply of doctors internally. Even France has 3.4 doctors per capita versus our 2.1. Market forces may be part of the reason costs are more reasonable in France. Obama could start a program and pay for medical educations in return for service in the government in the VHA or the armed services. This practically how all pilots get their educations paid for.
2) Increase the supply of doctors by lowering the testing requirements for doctors from other countries.
If the supply of doctors increases dramatically, if there's a doctor on every corner, prices should start to come down. Would it be possible to sue the AMA under the Sherman Anti-Trust Act?
3) Deal with the judicial system. I think perhaps a new system must be put in place to keep medical malpractice cases within reasonable limits. Mothers cannot sue doctors when the deliveries don't turn out perfectly. It may not be their fault that they cannot satisfy all mothers on the birth of their children. And so on. Perhaps we can borrow from the Europeans, who have special courts for such things. Three judges, all with expert medical experience, determine the judgments of medical malpractice cases.
The main benefiiciary of such a change would be the consumer, because then doctors may not have to order every test under the sun, and that alone will control costs.
These are just a few thoughts. If Obama is concerned with costs, there is much to do, if he can overcome the business monopolists. (I guess that would be as opposed to the government monopolists, who would like the government to monopolize it).