Tuesday, April 14, 2009

More On Health Care

From the New York Times Editorial page this past weekend:

Other than dealing with the economic crisis, health care reform is the most essential item on the Congressional agenda. It is imperative to lower the cost of health care, improve its quality, and cover tens of millions of uninsured Americans.

And a somewhat related anecdote from Arnold Kling (via Megan McArdle):

My oldest daughter is in her mid-twenties. She has a friend the same age who was stricken with cancer last year. She was treated with chemotherapy, Initially, the doctors thought this had worked, but now the cancer is back. My guess is that her prospects at this point are rather frightening.

That ends the anecdote. What follows is my imagination.

Imagine it were my daughter. What would be my attitude? I imagine that I would be walking into the oncologist saying, "Look. There has to be something you can try. I don't know whether it's bone marrow transplants or stem cells or some clinical trial somewhere. But we can't just sit here and watch her die. Either you give us something that has a chance of working, or we'll find another oncologist who will."

Next, imagine that the best hope is a treatment that costs $100,000 and offers a chance of success of 1 in 200. Would I want her to get that treatment? Absolutely.

But look at the issue from a rational, bureaucratic perspective. You have to treat 200 patients at a cost of $100,000 each in order to save one life, for a cost per life saved of $20 million. Is that what a rational bureaucracy would do?

A rational bureaucracy would not even tell the family about this treatment option. But I think that in the American culture regarding medicine, I would find out about it.

This semi-anecdote says nothing about free-market medicine vs. government health care. In my mind, free-market medicine is more likely to result in the treatment being attempted, but that is not necessarily an argument for or against free-market medicine.

While there are certainly inefficiencies in our current health care system, you'd have to live in a fantasy land to think there's an easy way to provide better coverage to more people at a lesser cost. The fact is that health care is expensive, quality health care costs more, and modern, high-tech, experimental treatments are even more so. Any bureaucracy, be it a big insurance company or a federal agency charged with health care spending faces the task of managing costs and no bureaucrat or third party is ever going to put the same value on the life of your family members as you do. Kling says this isn't an argument in favor of free market medicine, but isn't it? Or at the very least, isn't it an argument in favor of more choice for individuals, not less?


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