The "Costs" of Medical Care
By Thomas Sowell
We are incessantly being told that the cost of medical care is "too high"-- either absolutely or as a growing percentage of our incomes. But nothing that is being proposed by the government is likely to lower those costs, and much that is being proposed is almost certain to increase the costs.
There is a fundamental difference between reducing costs and simply shifting costs around, like a pea in a s game at a carnival. Costs are not reduced simply because you pay less at a doctor's office and more in taxes-- or more in insurance premiums, or more in higher prices for other goods and services that you buy, because the government has put the costs on businesses that pass those costs on to you.
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Thomas Sowell RealClearPolitics Health care
Costs are not reduced simply because you don't pay them. It would undoubtedly be cheaper for me to do without the medications that keep me alive and more vigorous in my old age than people of a similar age were in generations past.
Letting old people die would undoubtedly be cheaper than keeping them alive-- but that does not mean that the costs have gone down. It just means that we refuse to pay the costs. Instead, we pay the consequences. There is no free lunch.
Providing free lunches to people who go to hospital emergency rooms is one of the reasons for the current high costs of medical care for others. Politicians mandating what insurance companies must cover is another free lunch that leads to higher premiums for medical insurance-- and fewer people who can afford it.
Despite all the demonizing of insurance companies, pharmaceutical companies or doctors for what they charge, the fundamental costs of goods and services are the costs of producing them.
If highly paid chief executives of insurance companies or pharmaceutical companies agreed to work free of charge, it would make very little difference in the cost of insurance or medications. If doctors' incomes were cut in half, that would not lower the cost of producing doctors through years of expensive training in medical schools and hospitals, nor the overhead costs of running doctors' offices.
What it would do is reduce the number of very able people who are willing to take on the high costs of a medical education when the return on that investment is greatly reduced and the aggravations of dealing with government bureaucrats are added to the burdens of the work.
Britain has had a government-run medical system for more than half a century and it has to import doctors, including some from Third World countries where the medical training may not be the best. In short, reducing doctors' income is not reducing the cost of medical care, it is refusing to pay those costs. Like other ways of refusing to pay costs, it has consequences.
Any one of us can reduce medical costs by refusing to pay them. In our own lives, we recognize the consequences. But when someone with a gift for rhetoric tells us that the government can reduce the costs without consequences, we are ready to believe in such political miracles.
There are some ways in which the real costs of medical care can be reduced but the people who are leading the charge for a government takeover of medical care are not the least bit interested in actually reducing those costs, as distinguished from shifting the costs around or just refusing to pay them.
The high costs of "defensive medicine"-- expensive tests, medications and procedures required to protect doctors and hospitals from ruinous lawsuits, rather than to help the patients-- could be reduced by not letting lawyers get away with filing frivolous lawsuits.
If a court of law determines that the claims made in such lawsuits are bogus, then those who filed those claims could be forced to reimburse those who have been sued for all their expenses, including their attorneys' fees and the lost time of people who have other things to do. But politicians who get huge campaign contributions from lawyers are not about to pass laws to do this.
Why should they, when it is so much easier just to start a political stampede with fiery rhetoric and glittering promises?
Copyright 2009, Creators Syndicate Inc.
Page Printed from: http://www.realclearpolitics.com/art...are_98986.html at November 03, 2009 - 05:59:18 AM CST
Yet another red herring.
What percentage medical payouts are due to "frivolous" lawsuits.
My bet is that the percentage of serious lawsuits (real liability for killing or maiming) lost due to greenmail and exhaustion of the plaintiffs' finances by malicious defensive lawyering by corporate gunslingers is MUCH higher.
Last edited by boutons_deux; 11-03-2009 at 09:42 AM.
The only figure I have seen from a Republican says that tort reform reduces costs 0.5%.
I can see why Sowell chose to leave the number out of his column.
We've had tort reform in Texas since 2003. Maybe doctors will pass on their already substantial savings for liability insurance to Texans someday.
Still waiting...
Tort reform is only one of the points made in the article, why are the others being ignored.
We started with tort reform. The conversation can start anywhere.
Is there something preventing you from discussing the other points in the article?
Well apparently it ended there as well.
So then, you have nothing else to say either? If you remain silent, I can only conclude you're satisfied with the full stop as well.
Let's start with lessening the pool of available doctors.
Oh yes I'm satisfied I sort of expected it to stop there.
This is surely facetious.
Are you impersonating absent speakers again?
Or, finding ways to increase the pool by increasing the number of students in medical schools and increasing the pay of general prac ioners. There are many highly competent college students who would make great doctors but can't get into med schools and many of those who do are saddled with so much debt that they don't go into GP.
How's that?
Edit: Don't forget that in the UK there's no such thing as a PA. Every single patient is seen by an actual doctor. The concept of a PA is actually something the UK is looking to import from the US.
I agree with the debt being a deterent if there is no payout in the end. Which is something Sowell brought up. I don't think lowering the standard to get into med school should be the answer though.
Who suggested this?
How can you say Let's give everyone healthcare, and Let's not decrease the doctor's pay or the incoming amount of future doctors. Something has got to give. There is too much govt. intervention in all this.
I assumed that the reason they could not get into med school was because the they could not meet the standards.There are many highly competent college students who would make great doctors but can't get into med schools
I was always wondering what country are the liberals looking towards to say "this system works". Is England what America should focus on?
Yeah I think it would be great to find ways more kids can have the education made available to competent students.Also tax breaks or good loans given to people who are trying to open a practice.The more doctors we have the more choice we have, the more compe ion in services and cost we have.
It's funny you should say this. I have a sister whose been a dentist in a small rural community for about 25 years, she could make more money elsewhere,but she likes living there,but there is a goverment clinic that is undercutting all the local providers. Of course the care is worse there in the goverment clinics, because these all are new graduates, but it's cheap because it is subsidized.
End result is, it encourages private providers to leave to look for better pickings. It leaves the community at the benevolence of the state,and a revolving gang of providers who never establish a realtionship, once they serve their time they split for greener fields.
Your assumption, not Bartleby's.
Another plausible inference is that qualified students can't afford it.
You should ask that to a liberal...
I only brought up the UK since it was in the original article when trying to make a point about availability of doctors...
Good point nurse ratcheet.You know like the chick in one flew over a cuckoo's nest.
or the lack of available doctors.
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