Controlling Health Care Costs by Controlling Access
One of the things I have argued in the past that one way for nationalized health care to control costs is to limit the access to the system. When most people look at the costs of something they look only at the monetary costs. How much did we spend. The issue of opportunity costs almost never show up.
What are opportunity costs? Those benefits that are forgone when you choose a specific action. Suppose you have an hour of free time. You could read a book, watch television, or take a nap. You decide to read a book. The costs of reading a book are not taking a nap or not watching television.
How does this relate to health care issues? Simple, if you want to control for the dollar expenditures you can increase the opportunity costs. Triple the wait times. Will you want to go see the doctor when you think you have bronchitis if it means a 2.25 hour wait vs. a 3/4 hour wait? I bet lots of people might just decide to wait and see if they get worse before waiting that length time. This will save you money in the end. You aren’t expending health care resources on that individual who just walked out of the waiting room who did not see a doctor, have his blood pressure taken, his weight recorded, and so forth. Further, he is not going home with a prescription. All these things will save you money.
But there are still costs here, just not monetary costs. The person who walks out with bronchitis might take longer to recover. Hence more time off from work and that translate into lost production. Also, the person is sick longer which lowers his welfare which is also a cost. This merely hides the costs by transforming the costs from costs that have a monetary component to costs without the monetary component (at least ones that are not easily measured).
Now, Robin Roberts may have found an example of this from Canada’s health care system. Canada passed a law prohibiting payment for eggs. The only eggs that can be used in fertilization techniques are donated eggs. The result is to dry up the already small supply of eggs for fertilization techniques.
While Americans very publicly head to Canada by the busload for cheap prescription drugs, a growing number of Canadians are quietly coming here for medical treatment.
They aren’t coming to save money. In fact, they spend much more here than they would at home.
Nevertheless, Canadians are coming to the United States – and Colorado – for help in making babies.
Clearly there is a problem. Some Canadians are willing to pay for IVF procedures, but because of the nationalized nature of Canada’s health care system people are being prevented from engaging in these transactions (in Canada). While it might be seen as an “unintended consequence” it might very well be a way to limit health care costs. By prohibiting payment to egg donors the entire IVF procedure is no longer available in Canada which saves the Canadian health care system money.