Sunday, April 2, 2017

Buying without Paying. Legally.

When you can "buy" a product or service you want but charge it to someone else who you think can afford it, you'll buy more than you would if you paid for it yourself...unless you aren't human. The overall cost of providing those products and services will go up, not down, because more will be purchased than otherwise would. I illustrated this in a "Produce Stand" fable some years ago.

This is the fundamental issue in the health insurance debate. Mandated insurance or government provided "insurance" (i.e. through Medicare or Medicaid) make you think you can buy the medical services while someone else pays the bill for you. Frankly, the more your insurance premiums rise, the more you feel "entitled" to get lots of medical services: you feel even more justified in running to the ER, or getting a second opinion, or getting that extra test, or trying the other medicine. But someone has to pay for all the services you are getting.

As John Stossel put it in a recent column,

Someone else paying changes our behavior. We don’t shop around. We don’t ask, “Do I really need that test?” “Is there a place where it’s cheaper?”
Imagine if you had “grocery insurance.” You’d buy expensive foods; supermarkets would never have sales. Everyone would spend more.
Following is his complete column (with my emphasis added) which I heartily recommend.
Curt
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Free Market Care
By John Stossel

Apr. 2, 2017

President Trump and Paul Ryan tried to improve Obamacare. They failed.

Trump then tweeted, “ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE. Do not worry!”

But I do worry.

Trump is right when he says that Obamacare will explode.

The law mandates benefits and offers subsidies to more people. Insurers must cover things like:

—Birth control.

—Alcohol counseling.

—Depression screening.

—Diet counseling.

—Tobacco use screening.

—Breastfeeding counseling.

Some people want those things, but mandating them for everyone drives up costs. It was folly to pretend it wouldn’t.

Insisting that lots of things be paid for by someone else is a recipe for financial explosion.

Medicare works that way, too.

When I first qualified for it, I was amazed to find that no one even mentioned cost. It was just, “Have this test!” “See this doctor!”

I liked it. It’s great not to think about costs. But that’s why Medicare will explode, too. There’s no way that, in its current form, it will be around to fund younger people’s care.

Someone else paying changes our behavior. We don’t shop around. We don’t ask, “Do I really need that test?” “Is there a place where it’s cheaper?”

Hospitals and doctors don’t try very hard to do things cheaply.

Imagine if you had “grocery insurance.” You’d buy expensive foods; supermarkets would never have sales. Everyone would spend more.

Insurance coverage — third-party payment — is revered by the media and socialists (redundant?) but is a terrible way to pay for things.

Today, seven in eight health care dollars are paid by Medicare, Medicaid or private insurance companies. Because there’s no real health care market, costs rose 467 percent over the last three decades.

By contrast, prices fell in the few medical areas not covered by insurance, like plastic surgery and LASIK eye care. Patients shop around, forcing health providers to compete.

The National Center for Policy Analysis found that from 1999 to 2011 the price of traditional LASIK eye surgery dropped from over $2,100 to about $1,700.

Obamacare pretended government controls could accomplish the same thing, but they couldn’t.

The sickest people were quickest to sign up. Insurance companies then raised rates to cover their costs. When regulators objected, many insurers just quit Obamacare.

[Last] month Humana announced it’ll leave 11 states.

Voters will probably blame Republicans.

Insurance is meant for catastrophic health events, surprises that cost more than most people can afford. That does not include birth control and diet counseling.

The solution is to reduce, not increase, government’s control. We should buy medical care the way we buy cars and computers — with our own money.

Our employers don’t pay for our food, clothing and shelter; they shouldn’t pay for our health care. They certainly shouldn’t get a tax break for buying insurance while individuals don’t.

Give tax deductions to people who buy their own high-deductible insurance.

Give tax benefits to medical savings accounts. (Obamacare penalizes them.)

Allow insurers to sell across state lines. Current law forbids that, driving up costs and leaving people with fewer choices.

What about the other “solution” — Bernie Sanders' proposal of single-payer health care for all? Sanders claims other countries “provide universal health care … while saving money.”

But that’s not true.

Well, other countries do spend less. But they get less.

What modern health care they do get, they get because they freeload off our innovation. Our free market provides most of the world’s new medical devices and medicines.

Also, “single-payer” care leads to rationing.

Here’s a headline from Britain’s Daily Mail: “Another NHS horror story from Wales: Dying elderly cancer patient left ‘screaming in pain’ … for nine hours.”

Britain’s official goal is to treat people four months after diagnosis. Four months! That’s only the “goal.” They don’t even meet that standard.

Bernie Sanders' plan has been tried, and it’s no cure.

If it were done to meet American expectations, it would be ludicrously expensive. In 2011, clueless progressives in Bernie’s home state of Vermont voted in “universal care.” But they quickly dumped it when they figured out what it would cost. Didn’t Bernie notice?

It’s time to have government do less.

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