I Concur

Tyler Cowen:

More importantly, the claims "sound right wing" but actually they provide the best argument for single-payer health insurance to be found: "The link between health and health care is murky, so let's just save money on our health system."

A few important differences, though, since Cowen isn't actually a left-wing single-payer advocate. It's not just that you can save money, but there are also significant gains from the point of view of equality and social justice. What's more, a single-payer system does allow you to funnel additional health care resources to a handful of areas -- notably prenatal and postnatal care and pediatrics -- where it's uncontroversially the case that delivery of non-expensive services brings about some significant gains. Beyond that, though, if you want to make people healthier you need to talk less about health care and more about the dread lifestyle.

Comments

but people will not make the right lifestyle choices unless there is the threat of Big Insurance capriciously dropping them, or something.

Posted by theCoach | March 6, 2007 9:31 AM

Our current health care system does not grasp the seemingly simple concept of "prevention." Its focus instead is on hugely expensive interventions to treat problems that in many cases could have been prevented in the first place. Actually, that's one focus; the other is on hugely expensive treatments designed to prolong the lives of dying patients even though their chances of long-term survival and their quality of life are both zero. The concept of letting the very old and very ill go quietly and peacefully is, unfortunately, taboo.

Posted by Peter | March 6, 2007 9:32 AM

LOL--cheaper, better, and more available. But ideologically unappealing. And it would make some powerful businesses marginally less profitable.

Yeah, I can see why we'd sacrifice cheaper, better, and more available to keep big pharma fat and happy.

Posted by anonymous | March 6, 2007 9:41 AM

Peter - Unfortunately, the "old and dying" lobby is much more powerful than the prenatal lobby. You're right, though, and the problem is not confined to health care. We spend a pittance on early childhood development, education as a whole, etc., because that money is needed to pay for programs preferred by the AARP.

Posted by Mike | March 6, 2007 10:46 AM

Single-payer health care makes subsidization of better lifestyle choices cost-effective for that payer, while at present they're cost-effective for nobody. And that alone is a huge reason to go with single-payer.

There are lots of things our government could do to promote better lifestyle choices. It could eliminate or reduce subsidies for growing sugar or wheat, respectively, while subsidizing the growing of green vegetables. It could buy out the entire domestic tobacco products manufacturing and importing industries, and continue to operate them as at present, only without any advertising of any sort to lure new smokers into the habit. It could pay for an annual consultation with a dietitian. It could subsidize employers who build exercise facilities on site, and who provide secure parking and shower facilities for bicycle commuters.

The list is endless.

Posted by RT | March 6, 2007 11:16 AM

The list is endless...

And that is why I fight it. There is no end to the ways in which the government can take control of our choices, our knowledge, our decisions.

And that government changes hands every 4 - 8 years. Do you have no concept of the kind of harm a thuggish government could do with the control you so happily shower on your idealized angelic government?

Reality based community? I think not. You're not in the same fairyland as the republicans, but yours is just as fantastic.

"There are lots of things our government could do to promote better lifestyle choices."

Yes, they could kill everyone who smoked, drank or ate fatty foods.

Even better, they could sterilize everyone with bad genetic markers. That would solve the problem for good, wouldn't it?

Posted by jb | March 6, 2007 11:50 AM

jb,
The chance that we will get a worse administration than we currently have is extremely slim - I do not think the simple expression [ jb,
The chance that we will get a worse administration than we currently have is extremely slim - I do not think the simple expression [

"Yes, they could kill everyone who smoked, drank or ate fatty foods."

Yes, they could, in some theoretical way, but why in the world would they? 99+% of the electorate is related to someone who falls in that category. I also think you overstate the equivalence between ending wheat subsidies and totalitarianism.

Posted by theCoach | March 6, 2007 12:03 PM

shoulda previewed - the expression was less than 1 in 43.

Posted by theCoach | March 6, 2007 12:13 PM

JB - So, you're a libertarian, right? I think the mistake some people make is just assuming that the current order of things is somehow the 'natural' order. Actually, incentives always exist. Even government policy that attempts to be neutral will create certain incentives. So why not create incentives that will produce beneficial effects?

"Oh but what would a thuggish government do with our freedoms?"

Yes, what would they. Lets not elect one because what we do now with the widely accepted principle of tax incentives will have very little effect if we make that mistake again.

Any incentive program we choose has to be careful not to push too hard or too disruptively. That's about measuring the total cost of your policy and examining the total set of incentives you create. And what theCoach said about wheat subsidies.

Posted by mpowell | March 6, 2007 12:41 PM

"The chance that we will get a worse administration is extremely slim"

a) I think this statement is just dumb. One or two major crises and we're right back in "we need a strong, authoritarian leader to get the economy on track"

b) Even if I, for the sake of argument, agreed with you that the Bush administration is the worst we will see for the next 200 years, that doesn't change the fact that people can do horrible, terrible things for the very best of reasons. They outlawed alcohol, didn't they? There was a large eugenics movement last century. Those people thought they were doing the right thing.

I'm as much in favor as anyone in getting rid of subsidies and tarriffs on wheat, corn, sugar, steel, etc. But mandating office perks is rather invasive, don't you think? and seizing control of the tobacco industry???? Why don't we just ask Putin to take over as president and save ourselves the wait?

I mean - what if no one uses the "mandated workout facility". Wouldn't the next step be to "force people to exercise?" Isn't that the logical follow-on?

And once we seize the tobacco industry, why not nationalize the sugar industry? And the beef industry, and poultry, and corn, and so on and so forth? I mean, the precedent is there... And it's all in our best interests, right?

Posted by jb | March 6, 2007 12:54 PM

mpowell said "I think the mistake some people make is just assuming that the current order of things is somehow the 'natural' order."

Actually, the mistake most people make is thinking that the current order of things is the "baseline" and the world would be so much better if we just removed freedom X, Y and Z from that baseline. And every generation, the available freedoms shrink, except for a few very important added freedoms for women and african americans.

"Actually, incentives always exist. Even government policy that attempts to be neutral will create certain incentives. So why not create incentives that will produce beneficial effects?"

Because of the law of unintended consequences. Because no human being, no matter how smart, can properly anticipate and predict the way other human beings will respond to their policy decisions. Because every "incentive-based" policy decision creates new "special interests" that then lobby for the further expansion of those "incentives."

I'd add more, but I'm certain that you won't be swayed, nor will any other reader of this forum. Your faith in government is just too strong to be reasoned with :)

Posted by jb | March 6, 2007 1:08 PM

"Isn't that the logical follow-on? "

No, it is not. Thinking that it is a logical follow-on is frightening.

Posted by theCoach | March 6, 2007 1:09 PM

people really should seriously think about their health.not to live a mechanical life.one should take care about himself and also when ever he opportunity he should help others.similar pagesHealth & Safety Day 2007

Posted by Arcelor Mittal | March 7, 2007 1:43 AM