August 13, 2009

Economics of Our Health

There’s been a lot of talk lately about health care, especially at the suddenly very popular town hall–style meetings, which have seen both violence and passionate debate. As both David Stokes and I have argued, we are better off remaining civil. And, because health care is so important to us here at the Show-Me Institute, I thought I’d weigh in with some thoughts on health care reform.

If it were the case that a government solution, in the form of any act of Congress or national board of medical care, could provide service better than an actual competitive system, I would support it wholeheartedly, and would advocate it strongly. It’s worth pointing out, though, that what we have now is not a free market — it’s not even close.

Because of economic reality, no act of government would produce something better than a competitive system would, so long as the good or service in question is excludable (and medicine certainly is). This is because the price system operates in a way that produces an optimum allocation of resources, given limited availability of goods and information.

Health care in this country is broken because government intervention prevents competition from fixing it. Alleviation of licensing, regulation, and other burdens would encourage entrepreneurs to innovate cheaper forms of care. This is true not only of the providers of health care services, but also of health insurance provision. Right now, we are lucky we aren’t all getting the kind of “care” they get in McAllen, Texas. That’s a place where doctors are really exploiting the market power they are granted by the AMA monopoly and the current level of federally funded medicine (Medicare and Medicaid). I definitely recommend this New Yorker article — which we’ve linked to before — even though I disagree with the author’s conclusions about how to proceed, policy-wise.

And, for the record, medicine is not the best way to improve health. Sound counter-intuitive? Well, check this out:

our main problem in health policy is a huge overemphasis on medicine. The U.S. spends one sixth of national income on medicine, more than on all manufacturing. But health policy experts know that we see at best only weak aggregate relations between health and medicine, in contrast to apparently strong aggregate relations between health and many other factors, such as exercise, diet, sleep, smoking, pollution, climate, and social status. Cutting half of medical spending would seem to cost little in health, and yet would free up vast resources for other health and utility gains. To their shame, health experts have not said this loudly and clearly enough.

I added the emphasis for the “other factors,” because it’s important to realize which factors may make more of a difference than increasing medical treatment, which, unfortunately, is getting all the attention in the current debate.

The above quote is from a fantastic article by Robin Hanson. I HIGHLY recommend it to anyone concerned with making this country healthier.

Or, if you just want the latest coverage of Missouri’s town hall meetings from the Show-Me Institute’s roving reporter Audrey Spalding, check out her article on Policy Pulse.

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