Comments on: Making Excuses for the Massachusetts Failure

By: Matt

Matt — Sun, 28 Oct 2007 02:40:13 +0000

“If you will take off your ideological blinders for a few minutes, you will also be able to see the obvious.”

Surely you recognize the irony?

By: Catron

Catron — Thu, 25 Oct 2007 19:13:58 +0000

When it comes to performing tricks, I prefer concentrate on quality rather than quantity. But I’m more interested in your uncanny ability to miss the implications of your own analyses.

The core issue is demand. You prefer to think of it in terms of some conspiracy involving “unnecessary tests, hospitalizations and procedures.” I prefer to assign responsibility to the patients who receive the services. Either way, it is demand that puts upward pressure on insurance and health care prices in Massachusetts.

Where health care demand is concerned, Massachusetts is to the rest of the U.S. as the U.S. is to the rest of the world. This means that, unless our masters in Washington dictate how much care each patient receives, a universal health care plan for the whole country will have the same problems that the Massachusetts plan is having.

The reason that people like Arnold Kling were able to predict the Massachusetts failure with such accuracy is because they did not look at the issue through the lens of ideology. They just did the math. If you will take off your ideological blinders for a few minutes, you will also be able to see the obvious.

By: Maggie Mahar

Maggie Mahar — Thu, 25 Oct 2007 16:03:41 +0000

First, thanks very much for picking up the typo (in the awkward sentence).
Secondly, if you read the whole piece, you’ll find that I’m not saying that the citizens of Massachusetts “demand too much health care,” but they are accustomed to undergoing unncessary tests, hospitalizations and procedures because Masschusetts is a medical Mecca where an abundance of specialists and hospital beds drives demand.
It has long been known that, in the health care market, supply drives demand. (”Build the beds and they will come.) More than three decades of health care analysis done by researchers at Dartmouth University has shown that in areas of the country where there are more specialists and more hospital beds, Medicare spends twice as much per patient–after adjusting for differences in local prices, race, age and the underlying health of the population.
This research is now widely accepted by doctors, the Congressional Budget Office, the Medicare Payment Advisory Comission, etc. See my story about this research titled “The State of the Nation’s Health” and posted on the first page of http://www.tcf.org.
Scott– As to whether the consumer can create a transparent market and bring down prices, today I posted a piece on this very topic on my blog http://www.healthbeatblog.org –see “A Transaction Based on Trust.”
Finally, I’m afraid I agree with Matt: Catron is a one-trick pony.

By: Matt

Matt — Thu, 25 Oct 2007 01:43:19 +0000

A more cryptic statement has never been made.

You’re a one trick pony Catron, and it’s not that sturdy a horse.

By: Catron

Catron — Wed, 24 Oct 2007 20:57:53 +0000

I think most of the issues you raise would be resolved by deregulation of the insurance and health care markets. That would, in a relatively short time, align the incentives properly.

By: Scott

Scott — Wed, 24 Oct 2007 17:46:52 +0000

“The laws of arithmetic apply from sea to shining sea, and lame excuses won’t change that. Universal coverage is failing in Massachusetts because it’s a dumb idea based on preposterous economic assumptions.”

I agree with you, however maybe for not the same reasons.

Universal coverage will not work because it does not address the fundamental issues. However, the free market idea of abolishing employer based coverage and transferring everything to the individual insurance market (ie: personal responsibility) will not work either. Why? Again, it fails to address the fundamental issues that underlay most of the problems healthcare faces today.

No transparency = no competition = no incentives = no consumer market = status quo.

Under any system I have seen proposed the provider will continue too receive less then fair market value for services rendered which will lead too providers over charging and over treating which will lead to grossly over inflated premiums and finally leads to consumers (and employers) to continue to opt out of having / offering insurance (if they can get covered in the first place). In the end, the consumer will be left holding the bag for a system that excludes them from the start.

Just my opinion that has been simplified for the sake of sanity!