Quotulatiousness

August 10, 2009

Healthcare systems compared

Filed under: Cancon, Economics, Health — Tags: , , — Nicholas @ 12:55

No, not the usual red-in-tooth-and-claw US system of mercenary medicine against the shimmering city-on-the-hill of [Canadian | British | Swedish | Generic European] socialized medicine. This one is a bit easier to compare: human verses pet healthcare. Theodore Dalrymple discusses the issue:

As a British dog, you get to choose (through an intermediary, I admit) your veterinarian. If you don’t like him, you can pick up your leash and go elsewhere, that very day if necessary. Any vet will see you straight away, there is no delay in such investigations as you may need, and treatment is immediate. There are no waiting lists for dogs, no operations postponed because something more important has come up, no appalling stories of dogs being made to wait for years because other dogs — or hamsters — come first.

The conditions in which you receive your treatment are much more pleasant than British humans have to endure. For one thing, there is no bureaucracy to be negotiated with the skill of a white-water canoeist; above all, the atmosphere is different. There is no tension, no feeling that one more patient will bring the whole system to the point of collapse, and all the staff go off with nervous breakdowns. In the waiting rooms, a perfect calm reigns; the patients’ relatives are not on the verge of hysteria, and do not suspect that the system is cheating their loved one, for economic reasons, of the treatment which he needs. The relatives are united by their concern for the welfare of each other’s loved one. They are not terrified that someone is getting more out of the system than they.

And, yes, I know it’s extremely bad form to quote yourself, but here is what I wrote on the subject back in 2004:

It boggles the mind to think that it is possible for pets to receive faster, better-organized, more personalized, and more friendly healthcare than their human owners are able to get. And it’s absolutely true.

My wife works in a vet clinic. I know how much the staff at the clinic care about their patients and the families of their patients. They do their very best to ensure that the cats are properly diagnosed and treated. But they are paid for their work . . . by the families of the patients.

One of the comments on Marcel’s original post talks about “the Vet’s next Porsche purchase”. That by itself shows the utter ignorance of the commentator: you do not go into veterinary medicine to get rich. For the length of academic study, it’s probably the worst-paid bio-science field there is. The veterinarians, vet assistants, and vet technicians could all earn significantly higher wages in other fields for the same investment of time and money in training.

Medicine, whether for humans or for other animals, is an expensive field: typical Canadians don’t really know this, as a rule, because we don’t pay for it directly. Vets, as a rule, don’t have the latest and greatest equipment because they are running private businesses which have to finance equipment purchases out of their own funds. They generally have the best compromise they can manage between what’s available and what’s affordable.

Treatment for patients must be decided with an eye to costs: Fluffy may need treatment X, but if it’s going to cost hundreds or thousands of dollars, Fluffy’s owner is left with an unwelcome decision to make. We never think of this in terms of our own healthcare: instead of rationing by dollars, we ration by time. The resources are still scarce, but we pretend that delaying surgery for a painful ailment is better than paying extra to get the surgery done sooner; in fact, in Canada, there’s no choice involved at all.

The other pernicious effect of hiding the actual costs is to increase the demand for relatively trivial treatments (which could often be taken care of by family doctors, walk-in clinics, or even pharmacists). If you never see a bill, you never feel any reason to limit your personal demand on the system. It’s rational for you to extract as much personal benefit from the system as possible: you paid taxes to support it, right?

August 7, 2009

The error of being generous to your opponents

Filed under: Economics, Government, Health, USA — Tags: , — Nicholas @ 12:48

Megan McArdle is called to task for making a mistake . . . through being too generous to her opponents:

I erred so low because I was trying to be charitable to the cause of national health care. You see, the reason that insurance premia are so high in New York State is that New York State enjoys community rating, guaranteed issue, and a very generous bevy of mandatory services. The result is that the cost of insurance is very, very high. What I failed to realize was just how radically out of line New York’s rules had pushed its health care costs. The average premium across the United States has increased about 25% since 2004. In New York, the rate of inflation has apparently been about 16 times that. I wasn’t “aware” that insurance premiums have doubled and tripled over the last seven years, because for the country as a whole, this isn’t true.

So yes, John, the Atlantic’s economics expert didn’t realize just how much the kind of regulations Democrats are now pushing had managed to screw up New York’s health insurance market. In trying, while writing a blog post on the fly, to err on the side of charity towards my ideological opponents, I grossly misled my readers. Massive state interference in the insurance market is clearly much, much worse than I — the eternal pessimist! — managed to imagine. Thanks for calling that oversight to my attention.

Observe and report, citizen!

Filed under: Government, Politics, USA — Tags: , , — Nicholas @ 12:37

QotD: It’s not insurance, it’s welfare

Filed under: Health, Quotations — Tags: , — Nicholas @ 00:06

Have [New York Times writers and editors] no understanding of risk management? If it is controversial for health insurers to reject sick applicants, it should be controversial for life insurers to refuse to insure the already dead, and for car insurers to refuse to insure cars that have already been wrecked.

Doing that may be required by Congress and cheered by the New York Times, but that doesn’t make it a good thing for America. It doesn’t even make it insurance. It’s welfare. We can debate whether such welfare is good policy, but let’s discuss it honestly. Calling welfare “insurance” muddies thinking.

Requiring insurance companies to cover the sick takes away insurers’ power to encourage safer behavior. This will soon turn insurance into a form of expensive, taxpayer funded welfare.

John Stossel, “Welfare, Not Insurance”, John Stossel’s Take, 2009-08-05

July 22, 2009

Looking for Canadian health stats?

Filed under: Bureaucracy, Cancon, Health — Tags: , , — Nicholas @ 09:59

Kathy Shaidle has some useful advice for Americans who may be looking for information on the Canadian healthcare system.

Up here, the key word in discussions is “wait times”. That’s what we say, when you say “rationing.” The ONLY way for our system to work is to “hope” somebody ahead of you in the line for care dies, and you can take their place. A very cynical, nasty way to run a country, to say the least.

So go to Google.ca (especially the “News” section) and look up “wait times” if you want to get the real Canadian conversation on our health care system.

July 20, 2009

QotD: TANSTAARTHC

Filed under: Economics, Health, Liberty, Quotations — Tags: , , — Nicholas @ 12:37

There. I said it. Someone had to.

The acronym would be TANSTAARTHC. Nowhere near as euphonius as TANSTAAFL.

I broach the subject because I can’t seem to turn on a TV or radio without hearing, “Health care is a human right.” The phrase has entered the zeitgeist. Google it and you’ll get 25k hits. Google “right to health care” and you get 200k. Maybe I’m not listening hard enough, but I hear no one questioning its validity.

A right is intrinsic. It’s not given to you, it’s something you’re born with. Its existence is not dependent on the actions of others. In fact, only by the actions of others can it be taken from you.

F. Paul Wilson, “There ain’t no such thing as a right to health care “, Libertarian Enterprise, 2009-07-19

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