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The New Yorker: The Moral Hazard Myth
by Decius at 9:30 pm EDT, Sep 6, 2005 |
Americans spend $5,267 per capita on health care every year, almost two and half times the industrialized world’s median of $2,193; the extra spending comes to hundreds of billions of dollars a year. What does that extra spending buy us? Americans have fewer doctors per capita than most Western countries. We go to the doctor less than people in other Western countries. We get admitted to the hospital less frequently than people in other Western countries. We are less satisfied with our health care than our counterparts in other countries. American life expectancy is lower than the Western average. Childhood-immunization rates in the United States are lower than average. Infant-mortality rates are in the nineteenth percentile of industrialized nations
The counter point to this perspective usually consists of "sick people aren't my problem" or "wealthy people get more convenient healthcare in the US then in Canada." I am constantly amazed to talk to Americans who actually beleive that Canada is a socialist country. This spin is the product of Rush Limbaugh's rantings during the Clinton years. "Socialism is bad, right? Thats what the communists did, and they were evil!" The American healthcare system is both heavily regulated and wealth redistributed. Its just as socialist as anyone else's healthcare system. But it has the additional feature of generating a class of people with serious medical problems who are too sick to work and therefore don't get to participate in the wealth redistribution. Oh, and its more convenient for the wealthy because they never have to wait in line behind someone with a more serious problem unless they are at an ER. And its a hell of a lot more expensive. Gripping onto a ideology for ideology's sake while it is literally killing you seems the very definition of irrational behavior. On the issue the United States is like the last guy back in the hood in New Orleans, sitting on his couch with a foot of standing water in his living room, slowly succumbing to the E.Coli because its his damn town and he'll be damned if he is gunna leave, even after everyone else is long gone... Sounds like the Administration wants to get up off the couch and go for a swim. Don't worry about Europe hating us. If we keep going down this path they'll be laughing at us instead. |
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RE: The New Yorker: The Moral Hazard Myth
by Jamie at 2:17 pm EDT, Sep 7, 2005 |
Decius wrote: Americans spend $5,267 per capita on health care every year, almost two and half times the industrialized world’s median of $2,193; the extra spending comes to hundreds of billions of dollars a year. What does that extra spending buy us? Americans have fewer doctors per capita than most Western countries. We go to the doctor less than people in other Western countries. We get admitted to the hospital less frequently than people in other Western countries. We are less satisfied with our health care than our counterparts in other countries. American life expectancy is lower than the Western average. Childhood-immunization rates in the United States are lower than average. Infant-mortality rates are in the nineteenth percentile of industrialized nations
The counter point to this perspective usually consists of "sick people aren't my problem" or "wealthy people get more convenient healthcare in the US then in Canada." I am constantly amazed to talk to Americans who actually beleive that Canada is a socialist country. This spin is the product of Rush Limbaugh's rantings during the Clinton years. "Socialism is bad, right? Thats what the communists did, and they were evil!" The American healthcare system is both heavily regulated and wealth redistributed. Its just as socialist as anyone else's healthcare system. But it has the additional feature of generating a class of people with serious medical problems who are too sick to work and therefore don't get to participate in the wealth redistribution. Oh, and its more convenient for the wealthy because they never have to wait in line behind someone with a more serious problem unless they are at an ER. And its a hell of a lot more expensive. Gripping onto a ideology for ideology's sake while it is literally killing you seems the very definition of irrational behavior. On the issue the United States is like the last guy back in the hood in New Orleans, sitting on his couch with a foot of standing water in his living room, slowly succumbing to the E.Coli because its his damn town and he'll be damned if he is gunna leave, even after everyone else is long gone... Sounds like the Administration wants to get up off the couch and go for a swim. Don't worry about Europe hating us. If we keep going down this path they'll be laughing at us instead.
This story starts off talking about bad teeth and poor people without insurance having bad teeth. What about EVERY SINGLE PERSON in the UK? Are they all poor? |
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The New Yorker: The Moral Hazard Myth
by Mike the Usurper at 11:27 pm EDT, Sep 6, 2005 |
Americans spend $5,267 per capita on health care every year, almost two and half times the industrialized world’s median of $2,193; the extra spending comes to hundreds of billions of dollars a year. What does that extra spending buy us? Americans have fewer doctors per capita than most Western countries. We go to the doctor less than people in other Western countries. We get admitted to the hospital less frequently than people in other Western countries. We are less satisfied with our health care than our counterparts in other countries. American life expectancy is lower than the Western average. Childhood-immunization rates in the United States are lower than average. Infant-mortality rates are in the nineteenth percentile of industrialized nations
The counter point to this perspective usually consists of "sick people aren't my problem" or "wealthy people get more convenient healthcare in the US then in Canada." I am constantly amazed to talk to Americans who actually beleive that Canada is a socialist country. This spin is the product of Rush Limbaugh's rantings during the Clinton years. "Socialism is bad, right? Thats what the communists did, and they were evil!" The American healthcare system is both heavily regulated and wealth redistributed. Its just as socialist as anyone else's healthcare system. But it has the additional feature of generating a class of people with serious medical problems who are too sick to work and therefore don't get to participate in the wealth redistribution. Oh, and its more convenient for the wealthy because they never have to wait in line behind someone with a more serious problem unless they are at an ER. And its a hell of a lot more expensive. Gripping onto a ideology for ideology's sake while it is literally killing you seems the very definition of irrational behavior. On the issue the United States is like the last guy back in the hood in New Orleans, sitting on his couch with a foot of standing water in his living room, slowly succumbing to the E.Coli because its his damn town and he'll be damned if he is gunna leave, even after everyone else is long gone... Sounds like the Administration wants to get up off the couch and go for a swim. Don't worry about Europe hating us. If we keep going down this path they'll be laughing at us instead. [They won't be laughing, they'll be sending us aid as a third world country.] |
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RE: The New Yorker: The Moral Hazard Myth
by k at 11:04 am EDT, Sep 7, 2005 |
The counter point to this perspective usually consists of "sick people aren't my problem"
This is a common enough argument... i'm not sure it reflects the mainstream, or maybe i just hope that it doesn't. Social programs get the same treatment, of course.... "poor people aren't my problem." I think we could have a culture which supports both universal health care *and* social programs, but we're behind the ball on the language here. The stigma of socialism (undeserved, as it may be) makes a real discussion difficult, because a large percentage of people simply turn off and resort to, as you said, "SOCIALISM BAD!" Simultaneously, we've gotten to a point where "TAX" is a four letter
word. You say it, and all useful debate becomes moot, because, like socialism, all taxes are bad. Americans also tend to have an inherent distrust for government (and this carries over to all large bureaucracies). Certain political factions have exploited this philosophical underpinning and both expanded and distorted it to the point where the average guy resents paying his taxes, even when he well knows what services it pays for and is in favor of them. I think it's become so implicit that bureaucracy is wasteful and inefficient that we are crippled to even accept the notion that it may not be so. Certainly I'm all for ensuring that the maximum of my money goes to provide actual services and if we can minimize overhead while providing the same level of service, I'm for that. Does that make me a fiscal conservative? I can't tell anymore. I've checked on charities before and given to one over another because more money gets to the people who need it. That's smart (i think), and applying similar metrics to the gov. should be encouraged. At any rate, what this article shows is that health care is becoming less good at redisribuing wealth... and that the trends we are establishing, far from reducing the burden, will increase it. It's not insurance if it doesn't provide what i'm going to need. But, you know, redistributing wealth is just a fancy way of saying "Steal from the rich..." right? That mentality is going to be hard to overcome. The article also touches on issues of preventitive care vs. urgent or critial care. I can't recall a study that doesn't say that staying healthy is cheaper than getting fixed. But we have a mentality in this country that it's a waste of time and money to go to the doctor when nothing is wrong. If nothing else, i don't think a massive economic study is necessary to posit that if we get everyone doing preventitive medecine, our costs will go down *substantially*. Ultimately, I think the health care issue will reflect itself in other economic sectors as we either lose, or fail to gain, good jobs and smart people because they won't risk their family's health. |
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RE: The New Yorker: The Moral Hazard Myth
by skullaria at 1:02 am EDT, Sep 9, 2005 |
Well, from my own experience, our healthcare flat SUCKS. Maybe I am not rich enough to get to enjoy the 'speed of our healthcare.' Maybe I just have a bitchass HMO, but I had a high priced PPO and it was no different. The insurance companies that are for profit are telling the doctors what to do and when they can do it. Let's see - a broken bone that 3 doctors couldn't seem to diagnose (they didn't want to do new x-rays) but that I KNEW existed....leading to death of the bone....then 9 more years of begging someone to x-ray it or something because it hurt....then 6 months after I finally got the freaking x-ray to be able to get an appointment with an orthopedic surgeon...then... through 2 years of 'prescribed conservative treatment' when my doctor knew immediately what my problems were and wanted to do surgery. I couldn't have the surgery until I ran on the conservative treatment treadmill for 2 years, during which time, the conservative treatment that the HMO prescribed actually exacerbated my RLS, which is now so very severe and my nerve damage so extensive that they say I cannot have the surgery that I needed to start with and it would not work NOW anyway. So here I am with a neurological disorder from HELL that compels me to walk to relieve the pain and I can't even freaking walk. So, I just can't see how a person could hate the US's wonderful healthcare system as much as I do. IT DOESN'T FREAKING WORK and it costs out the ASS! |
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The New Yorker: The Moral Hazard Myth
by Lost at 2:22 am EDT, Oct 11, 2005 |
If you think of insurance as producing wasteful consumption of medical services, then the fact that there are forty-five million Americans without health insurance is no longer an immediate cause for alarm. After all, it’s not as if the uninsured never go to the doctor. They spend, on average, $934 a year on medical care. A moral-hazard theorist would say that they go to the doctor when they really have to. Those of us with private insurance, by contrast, consume $2,347 worth of health care a year. If a lot of that extra $1,413 is waste, then maybe the uninsured person is the truly efficient consumer of health care.
The moral-hazard argument makes sense, however, only if we consume health care in the same way that we consume other consumer goods, and to economists like Nyman this assumption is plainly absurd. We go to the doctor grudgingly, only because we’re sick. “Moral hazard is overblown,” the Princeton economist Uwe Reinhardt says. “You always hear that the demand for health care is unlimited. This is just not true. People who are very well insured, who are very rich, do you see them check into the hospital because it’s free? Do people really like to go to the doctor? Do they check into the hospital instead of playing golf?”
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