Category Archives: Health

Hospital Costs

Why the huge variation? It’s because of the huge disconnect between the consumer and provider. When a third party pays, all transparency, and need for it, is lost. As Glenn writes:

You could do more for real cost control by requiring hospitals to publish fixed prices for most procedures than from any amount of bureaucratic fiddling — though such an approach would provide disappointingly few opportunities for graft.

When I got my hernia fixed last year, I didn’t just shop doctors, I shopped surgery facilities and even anesthesiologists. Because I was paying for it.

The Oregon Medicaid Study

Why it should change our thinking about health insurance and health care:

A bunch of people sarcastically asked whether I was planning to drop my health insurance. The answer is no, because my employer pays for it. But if the question is “Has this caused you to revise downward your estimate of the value of health insurance?” the answer has to obviously be yes. Anyone who answers differently is looking deep into their intestinal loops, not the Oregon study. You don’t have to revise the estimate to zero, or even a low number. But if you’d asked folks before the results dropped what we’d expect to see if insurance made people a lot healthier, they’d have said “statistically significant improvement on basic markers for the most common chronic diseases. The fact that we didn’t see that means that we should now say that health insurance, or at least Medicaid, probably doesn’t make as big a difference in health as we thought.

Certainly, this bolsters my belief that health insurance should provide financial protection from catastrophic events, not wrap-around first-dollar coverage. Those who used to read me on The Atlantic may recall that the McArdle Plan for Healthcare involved the government picking up the tab for any medical expenses above 15-20% of income: simple, progressive, and aimed at the actual problem we know health insurance can fix. Unfortunaely, Obamacare made that sort of coverage functionally illegal.

And that was the kind of coverage I’ve always purchased for myself. That is, true health insurance, not what the moron Sibelius thinks is health insurance. And they want to make it impossible for me to get it.

Gun control isn’t about guns — it’s about control. And health care isn’t about health — it’s about control. The thing is never about the thing.