O, Canada. We on the left like to hold up your healthcare system as an example. Those on the right attempt to do the same. But they get it wrong.
Mythbusting Canadian Healthcare, pt 1
Mythbusting Canadian Healthcare, pt 2
Good reads, both. Especially if you want the ground-level view from someone who lives there to use against people who speak loudly about it even though they don’t have first hand knowledge of it.
John Dawson | 13-Feb-08 at 6:05 pm | Permalink
Definitely an interesting read. It makes a plausible case for why America would benefit if we switched to a government-run insurance plan like this.
Meanwhile, back in libertarian-land, I’ve had my own ideas about what’s wrong with our health care.
I think the root cause of skyrocketing-out-of-control medical costs is doctors themselves; specifically, their monopoly power to administer health care. Medical costs are high because we’re in a monopoly market.
Doctors are scarce, and will remain scarce, because the process of becoming a licensed medical doctor is, purposefully, extremely onerous. This means they can charge a lot of money. And further, we expect doctors to know everything, and never screw up. If they do, we sue their pants off. This drives costs up.
Now, I love doctors, and I’m a big believer in Western medicine, and the scientific method. I reject quackery of pretty much all kinds. But, wouldn’t our medical costs go down if we just relaxed the requirements about who could provide medical care, and the expectations for those people?
The vast majority of doctor’s visits, for me and my family, consist of interactions like this: I see the doctor; he examines ear/nose/throat and says “Yep, you’re sick”. The lab (not the doctor!) runs a blood test. It gets classified as either viral (drink fluids and rest) or bacterial (antibiotics are prescribed). Surely somebody doesn’t need to go to med school for 10 years for this.
Why not make it legally permissible for cranks and quacks, or even people with (gasp) just a couple of years of medical training, to do this? Let the doctors spend time on hard stuff.
My office is currently in the Whole Foods building in Austin, TX. When I go into the store, I see shelf after shelf of ridiculous snake oil products. The idiotic enviro-yuppies who shop there buy these and feel they’ve cleansed their body of toxins holistically and are letting the body heal itself naturally so they’ll be immortal. Are they crazy? Yes; they should google “placebo” and spend some time reading up on it. But if all these people were to forego seeing real doctors and instead saw witch-doctor types, that would increase the relative supply of doctors for the rest of us.
If we de-monopolized doctors, and let mere mortals prescribe antibiotics, I’m sure there would be some harmful side effects. There would certainly be deaths. But if the US is currently spending 15% of its GDP (according to the articles linked above), and we could drastically reduce that percentage, that is worth a lot of lives. Imagine if we reduced it to 5% of GDP, and freed up 10% of GDP to, say, balance the budget, staving off the looming complete collapse of the American government; or to fund education; or even to fund long-term medical research stuff like curing cancer. That’s is worth some lives lost in the short-term; and remember, nobody is forcing anybody not to see doctors. If you want the best care, see the doctor. If you just want something for your sinus infection, see somebody with 2 years of night classes from a community college, or buy stuff over-the-counter.
Lono | 21-Feb-08 at 3:18 pm | Permalink
Seconded…
In other words
Vote Ron Paul FTW!!!
(I Did – even tho I had to expose myself to the Republican Cacus to do it)
Seriously tho – write in the best candidate don’t let the absurd 2 party system decide for us – or the terrorists win!
(and he IS a M.D. after all…)
John Dawson | 22-Feb-08 at 4:22 pm | Permalink
Here’s a link to a site which suggests what might happen if we let non-doctors prescribe medicine and pretend like they know how to administer health care:
http://www.economist.com/displaystory.cfm?story_id=10727817
Ah, India, that lovely Petri dish of free-market capitalism …
But perhaps there’s a happy medium between expensive, doctor-controlled medical monopoly, and having outright quacks putting up a shingle and pretending they’re doctors, with the attendant disastrous results.
yongi | 23-Feb-08 at 9:34 am | Permalink
Perhaps, Herr Dawson, you might be interested in promoting the work of Nurse Practitioners and Physician’s Assistants as opposed to actually opening things up to quacks? Unfortunately, there’s a lot of promotion necessary…
You’re almost related to an NP by marriage (Dr. Evil’s wife is one), and she tried for a while to run her own clinic to serve the uninsured in Southeast Texas. But it’s a hard business to make work and they had to shut down. Part of what they were missing was good operating capital. In other words, not enough patients.
Maybe, just maybe, the poor and uninsured of the country would like to be able to see a “regular” doctor just as much as wealthy software developers with a love of the free market? In that case, the free market itself appears to fight against the very libertarian solution you propose.