Thursday, September 25, 2008

Re: Government Should Provide Healthcare

In regard to my previous post, all I am hearing is how government-run healthcare is not the best form of healthcare. I never argued that is was. I simply said that it is our best bet to improve the current situation. I am waiting for someone to argue to me why either 1) we are better off in the current in-between system, or 2) that it would be easier and more practical to switch to a privatized system. Here are my arguments why government healthcare is the most feasible.

Politicians in general do not understand economics. We all scratch our heads as to why politicians just don’t implement sound economic policy that, if modeled, is very clear that it’s the right way to go. Well, politicians are, obviously, elected by the people. The population at large doesn’t understand economics. For the public to be convinced that privatized healthcare is the best, they must have some basic understanding of economic principles. A lot of economic policy, when first glanced at, seems to be backwards and contrary to its ends. We, as economic students, all know that even though it seems strange, free market economics can work. For instance, most people don’t understand that by instituting a minimum wage, the demand for labor decreases, and thus, people are laid off. People don’t get that by instituting a policy that is designed to help people, you are actually hurting them. When economists argue against minimum wage, the people interpret that to mean economists (or politicians) are arguing against giving people more money, or in essence, keeping more money for themselves. The public asks, how can anybody be against giving people more money? Thus, sound economic policy is not implemented.

My point is that even though privatized healthcare is clearly the best option, it is not realistic because people don’t understand it. What they do understand is government. A politician advocating for government healthcare is something people can wrap their heads around. Therefore, it has a chance of gaining a foothold and is much more likely to be put into practice. So even though privatized healthcare is better than government healthcare, they are both better than the current system we have now. And since privatized healthcare is unrealistic because the people will never follow the politicians there (and the politicians will never lead the people there), our best option for improving our current situation is by giving responsibility for providing healthcare over to our government.

Of course, if I could build a country from scratch, from the ground up, I would institute a private system of healthcare. But one almost has to start from the very beginning. Given our current political makeup, it would be virtually impossible to switch to a completely privatized system. It is hard to change a foundation without destroying the house. So what I am waiting for is for someone to argue to me that we could institute privatized healthcare given our current political climate. I am not asking for theory, or what could happen in a utopia. I am asking for someone to face reality and present a sound argument for a feasible switch to private healthcare. Or, argue to me that our current system of somewhere-in-between-private-and-government is better than government-run healthcare, therefore we shouldn’t switch.


Michelle Rennolet said...

Basically, I just have one question: why do you assume that government would run a healthsystem any better than they "run" the economy?
Judging by what I've heard from the people who live in countries with government healtcare, the quality rapidly declines.
For instance, my German teacher in high school knew a guy who had a sore tooth, and it took him a year (!!!) to be allowed to see the dentist. Then the dentist pulled the wrong tooth. Now he makes a trip to the US every year for dentist and doctor visits so he doesn't have to wait forever for poor quality medical care.

Jaeson Madison said...

First off I’d like to say I agree with you that privatized healthcare is something of a dream. Perhaps a dream worth pursing, but then again so is the pot of gold at the end of the rainbow, and you probably have better odds of catching the latter.

That I being said, I’m completely at odds with your assertion that of the three possible methods of allotting healthcare, intervention is the worst. I apologize in advance that to explain this position I’m gonna have to ramble more then is commonly expected for a blog reply. But as you said in an earlier post this is a complicated issue. Just thank whichever deity you prefer that I don’t break out the entire contents of a research project I did on this subject some time ago.

Setting aside privatization as a wonderful, but unattainable, pipedream, let’s simply do a quick comparison of intervention versus socialization. Specifically, in order to add some concreteness to a theoretical discussion, let’s talk about Canada’s government provided healthcare versus the United States version of half and half.

Now to begin with I don’t know anyone who goes to Canada for medical treatment. Perhaps for prescription drugs, but that’s an entirely different argument. However, I am friends with at least one Canadian and acquaintances with a few others, and they absolutely do come here for medical treatments. In fact that’s when I’m most likely to see them, when they come stateside looking to nip into a hospital for whatever reason. Furthermore, I have some family in Michigan, and they’ve taken to boasting about their growing status as the transplant capital for Canadian citizenry. If the socialized system in Canada was so much better then our intervention version, stories like this simply wouldn’t exist. Especially when you consider in order to seek treatment here Canadians essentially have to pay twice, first through their mandatory payouts to their system in taxes, and again to our local doctors when they make their cross border visit.

The question is why do they bother? We could talk about quality of care, but this is a nebulous concept at best. For example, I like my doctor because he doesn’t harp on the fact that I’m fat and have high blood pressure. This would seem like dereliction of duties to some, but the honest truth is I’m not going to change just because he harps, and I’m happier not having to hear it. Quality care to me, dangerous lack of quality to others.

No, I think the most quantifiable thing we can trace it back to is waiting times. My mother had a surgery last year that from diagnosis, to specialist appointment, to actual procedure took about a week. In contrast several years back I did a report on Canada’s healthcare, and discovered the average waiting time for a similar thing would have been a little over 19 weeks, and rising fast. Time, especially with medical care, is of the essence. But when the system is clogged with everybody wanting their share (or more then their share, because the cost is now hidden and whatever looks free suffers a massive rise in demand), and no way of allocating resources beyond mandates (which I think we can agree don’t work with the same urgency or effectiveness as prices, intervention or not) things get bogged down and everyone suffers.

Finally do you get doctors under socialized medicine? Canadians might tell you no. Their rate of enrollment at medical schools has been steadily declining. Granted we have a nurse shortage here in the United States so the question, as far as comparison, might still be up in the air. Thus I, again, turn to personal anecdotes. I had a friend who was hoping to get into medical research after finishing college but ended up straying away from this goal when he noticed the clear threat of socialized healthcare really beginning to grow a few years back. Thus under intervention we would have gotten him, under even the possibility of government control he opted out. And I bet he’s not the only one.It takes quite a bit of time and money to get a relevant degree for working in any facet of the healthcare system, and those smart and well read enough to have at least a basic understanding of economics (and I hope we can include at least most doctors and medical researchers in this category) realize that if the government takes over the healthcare system the odds say their pay is going to drop somewhat and suddenly paying off all those college loans and making the time invested worthwhile is far from guaranteed. Intervention doesn’t get you the efficient allocation of doctors privatization would, but it would appear to get you closer to that number then socialization.

So while it’s true intervention isn’t the ideal that privatization might be, I certainly don’t think it’s the hellish dregs that socialized care is. Going to socialization just because we can’t get to privatization seems to be a clear case of cutting off your nose to spite your face.