Friday, April 22, 2005

Access Denied--That'll be $100, Please

Paul Krugman's latest in the New York Times points to one of the ironies of the US health "system," namely, the fact that several million administrative employees suck up health care dollars in exchange for denying claims and/or passing the buck (his phrase) to other providers of last resort, like Medicaid:

At a rough guess, between two million and three million Americans are employed by insurers and health care providers not to deliver health care, but to pass the buck for that care to someone else. And the result of all their exertions is to make the nation poorer and sicker.

Why do we put up with such an expensive, counterproductive health care system? Vested interests play an important role. But we also suffer from ideological blinders: decades of indoctrination in the virtues of market competition and the evils of big government have left many Americans unable to comprehend the idea that sometimes competition is the problem, not the solution.

As an aside, he brings up a point that others have noted in arguing that, eventually, this country MIGHT do the rational thing and adopt a single-payer public health system--if only because employer financed benefits are creating an uncompetitive burden on business: the U.S. system, medical costs act as a tax on employment. For example, General Motors is losing money on every car it makes because of the burden of health care costs. As a result, it may be forced to lay off thousands of workers, or may even go out of business. Yet the insurance premiums saved by firing workers are no saving at all to society as a whole: somebody still ends up paying the bills.

I guess this is as good a time as any to also note that Ezra Klein has been posting a series he calls The Health of Nations, with Japan and Germany the latest installments. Thus far, I've found his posts easy to read, but plenty informative enough. France, England, and Canada have also been looked at. Check them out yourself if you feel like it.

My own take on health care is "here's hoping I don't get sick..." AND I HAVE insurance...

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