Comments on: Market Based Medicine http://www.outsidethebeltway.com/archives/market_based_medicine/ Online Journal of Politics and Foreign Affairs Wed, 25 Nov 2009 10:36:53 -0600 http://wordpress.org/?v=2.8.5 hourly 1 By: LaurenceB http://www.outsidethebeltway.com/archives/market_based_medicine/comment-page-1/#comment-162010 LaurenceB Thu, 20 Sep 2007 13:31:59 +0000 http://www.outsidethebeltway.com/archives/2007/09/market_based_medicine/#comment-162010 <blockquote>Regardless, the current system is anything but market based (few of us have much incentive to care what our health care costs beyond the monthly premiums and deductibles) and there’s zero public appetite for making it more so.</blockquote> I can understand why the current insurance-based system is described ny JJ as "anyting but market based" - given that it lacks many of the standard open market characteristics. but I think it's important to note that the system is, indeed, <em>market-produced</em>. In other words, the current system with all its flaws is the result of a relatively free open market system allowed to run it's course. Individuals recognized the need for insurance, so they bought insurance in an open market. Employers recognized they could attract employees by offering health insurance at lower rates by bargaining group rates with insurance companies - all within the market system. The result of these market-based transactions is the system we have now. That being the case, I think JJ is off-base when he states that there is "...zero public appetite for making it more [free market]...". Ask yourself this question: How would it be possible to make the current system more of an open market than it already is? (And remember that making laws or policies that would regulate or exclude insurance companies or employers from offering health insurance is <em>less</em> open market, not more.) The only answers to that question I can come up with are small tweaks to the tax code, or such. The bottom line is that today's failing system is largely the product of an open market. Sometimes that happens.

Regardless, the current system is anything but market based (few of us have much incentive to care what our health care costs beyond the monthly premiums and deductibles) and there’s zero public appetite for making it more so.

I can understand why the current insurance-based system is described ny JJ as "anyting but market based" - given that it lacks many of the standard open market characteristics. but I think it's important to note that the system is, indeed, market-produced. In other words, the current system with all its flaws is the result of a relatively free open market system allowed to run it's course.

Individuals recognized the need for insurance, so they bought insurance in an open market. Employers recognized they could attract employees by offering health insurance at lower rates by bargaining group rates with insurance companies - all within the market system. The result of these market-based transactions is the system we have now.

That being the case, I think JJ is off-base when he states that there is "...zero public appetite for making it more [free market]...". Ask yourself this question: How would it be possible to make the current system more of an open market than it already is? (And remember that making laws or policies that would regulate or exclude insurance companies or employers from offering health insurance is less open market, not more.)

The only answers to that question I can come up with are small tweaks to the tax code, or such. The bottom line is that today's failing system is largely the product of an open market. Sometimes that happens.

]]> By: M1EK http://www.outsidethebeltway.com/archives/market_based_medicine/comment-page-1/#comment-161190 M1EK Wed, 19 Sep 2007 19:02:59 +0000 http://www.outsidethebeltway.com/archives/2007/09/market_based_medicine/#comment-161190 And to forestall the inevitable riposte - no, I don't think that if businesses stop paying for health insurance, that we'd be any less likely to have this problem - more likely, in fact, under individual insurance contracts that you'd just get dropped whenever there's a glimmer of something potentially expensive coming down the road. And to forestall the inevitable riposte - no, I don't think that if businesses stop paying for health insurance, that we'd be any less likely to have this problem - more likely, in fact, under individual insurance contracts that you'd just get dropped whenever there's a glimmer of something potentially expensive coming down the road.

]]> By: M1EK http://www.outsidethebeltway.com/archives/market_based_medicine/comment-page-1/#comment-161188 M1EK Wed, 19 Sep 2007 19:01:26 +0000 http://www.outsidethebeltway.com/archives/2007/09/market_based_medicine/#comment-161188 The direction we're going is the correct one - which is obvious if you've had any experience at all with changing health care "providers" (I've had 6 or 7 during my working career) instead of being the typical academician who gets good coverage and rarely changes. An even-more-market-oriented system than what we have now would provide even less incentive for insurance companies to invest in treatments which have long payoff times, even if those treatments will make the patient much better and save money in the long-run. This is already a problem, but gets worse as you inject more "market magic". Why on earth would you expect your insurance company to pay for a cheap treatment now which pays off in 5-15 years (avoiding a very expensive one) if the chance that they'll be your insurance company in 5-15 years is low? The direction we're going is the correct one - which is obvious if you've had any experience at all with changing health care "providers" (I've had 6 or 7 during my working career) instead of being the typical academician who gets good coverage and rarely changes.

An even-more-market-oriented system than what we have now would provide even less incentive for insurance companies to invest in treatments which have long payoff times, even if those treatments will make the patient much better and save money in the long-run. This is already a problem, but gets worse as you inject more "market magic". Why on earth would you expect your insurance company to pay for a cheap treatment now which pays off in 5-15 years (avoiding a very expensive one) if the chance that they'll be your insurance company in 5-15 years is low?

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