Arnold Kling writes about the little-known history of prostitution insurance.

Kling's column is excellent, as are most of his columns.

Kling is an idiot.

Medical services come in both neccessary and optional levels.

When you go to the ER, it's usually vital. YOu have very little
choice, the need is there, and you pay what you have to or can.
Nobody lays on a stretcher bargaining over a CAT scan price.

When you go to a brothel, it's a choice.
Nobody has to go a hooker/dominatrix/fetishist,

An inability to distinguish between wants and needs is a
classic failing of neoconomics.

One has no more need to go to a brothel then one has to
go to a plastic surgeon.

An actual coherent argument!

Of _course_ we should be bargaining over the price of our CAT scans! Currently, we have practically zero incentive to do so. Generally, one doesn't even get an estimate of a procedure's cost in advance. Let alone a _second_ opinion, or shopping for price.

Anonymous, neoneocon, who knew.

When you go to the ER, it's usually vital. YOu have very little
choice, the need is there, and you pay what you have to or can.
Nobody lays on a stretcher bargaining over a CAT scan price.

And even the dimmest hospital or doctor knows that. A situation where a customer has poor knowledge and urgent need is easily exploited.

Medical service providers, like other service providers, tend to charge more, and to control costs less effectively, when they are paid by third parties rather than directly by their customers. This is empirically true and Kling makes the point in an entertaining way.

So Kling is an idiot because paid sex and ER treatment are not the same thing? Kling does not argue that they are, merely that providers of medical services respond to incentives as other service providers do. Yours is the classic response of the economic ignoramus who insists that empirical relationships that hold for other commodities somehow are invalid for oil/gold/medicine/whatever.

There are many kinds of emergencies. Ever need to get your car fixed or a brochure printed or obtain some other kind of professional service on a weekend evening? Somehow most services are available at reasonable prices, without government intervention, as long as competitive markets are allowed to exist. It's government regulation that kills competitive incentives and drives up prices. Which was Kling's point.

Generally, one doesn't even get an estimate of a procedure's cost in advance.

I do. I just tell them that I self insure, and ask them what it will cost.

if Kling had talked about "Food Insurance" and how
some companies began having Meal plans
he might have a point.

Almost everyone who goes to college who is in dorms is on
the meal plan. No choice, it is what it is, and afer a 3 day hunger strike, you aren't fit for class.

You need to meet the tests of classical economics.

As for Simberg, I wonder if he's been in an ER.

Anonymous, you are confused, to put it mildly. You seem to be rotating through the following assumptions:

-Lack of choice is a necessary feature of medicine in general.

-Lack of choice is a necessary feature of emergency medicine in particular.

-Lack of choice is a necessary feature of the health-insur$nce market.

Yet you never explain why you think that these assumptions are valid. For example, what does a student meal plan have to do with health insurance? I can buy any health insurance that I want, or go without and self-insure, so your meal-plan metaphor doesn't fit.

Are you capable of making a clear argument that isn't based on weak assumptions or question begging?

Jonathan

What choice does one have in emergency medicine?
when you are injured in the ER, what choice do you have?
What choice in service or price do you have there?
So wether you self insure or have insurance, what
affect is there on price or cost?

For the market for medical neccessities, particularly, time - critical
neccessities, what choice or substitution exists?

when you are injured in the ER, what choice do you have?

None, but at least you get seen in a reasonable amount of time and receive care for your trouble. You also cannot be turned away. If your so sick or injured that your life might be at risk, do you want to haggle? If your not so sick or injured, do you need to go to the ER? I had a terrible stomach flu two years ago and went to the ER. I was dehydrated and really sick. I received a shot and a prescription and then a week later (after getting better) the bill. I just finished paying that bill four months ago. Oh, and during the ER visit, I was uninsured. All better, bill's finally paid, and everybody's happy. Its not a perfect system, but it works better than most.

Anonymous, what choice does one have in emergency automobile repairs? Somehow medicine is seen by many people as a special case when really it is little different, in economic terms, from many other services. There are always tradeoffs, and one of the most common tradeoffs is quicker service and higher prices vs. slower service and lower prices. That's just how the world works, and it's up to customers to decide which of the available alternative they prefer. Kling is pointing out that government interference in markets generally worsens the set of available alternatives.

Jonathan Asks:

"What choice do you have in emergency auto repairs?"

Easy.

1) Walk

2) Bus

3) Bike

4) Hitchhike

5) rentawreck

So

When the ambulance takes you to the ER, what choice
does someone have?

as for Kling, he's an idiot.

Nope. A broken car when you have time to take a bus or bike is analogous to a medical problem where you have time to shop around and compare treatments. That's not an emergency. In an emergency -- medical, or your car breaks down in the middle of nowhere on the way to an important meeting, or your plumbing clogs an hour before a big party -- you have little choice and you usually have to pay up. That's why it's called an emergency. Markets handle the possibility of emergencies by creating big monetary incentives for service providers. Government regulators handle the possibility of emergencies by putting beds in hospital halls so that people who are having strokes can wait patiently for their free medical care.

And you still don't know what you're talking about and I'm done here.

Jonathan

Hate to break it to you, but, the only emergency auto repair
is one where if you don't fix it soon, you die.
That would be to my mind, breaking down in the desert,
in a blizzard, or in the path of a train. The choices in these
kinds of situations usually entail finding shelter until
the storm blows over.

if your car breaks down at a wildly inconvenient time or place
say on I-95 half way to Florida, or an hour before a meeting,
you still have lots of options hailing from calling a friend,
to renting a car.

No car repair is even remotely comparable to a true
medical emergency.