Tuesday, March 20, 2012

Notes on Heath Care Econ and the Mandate

In reality, the mandate has almost nothing to do with cost-shifting. The targeted population—the young, healthy and not poor who choose to forgo coverage—has a minimal role in the $43 billion of uncompensated health-care costs. In 2008, for example (the latest figures available), the Department of Health and Human Service's Medical Expenditure Panel Survey showed that the uncompensated care of the mandate's targeted population was no more than $12.8 billion—a tiny one-half of 1% of the nation's $2.4 trillion in overall health-care costs. The insurance mandate cannot reasonably be justified on the ground that it remedies costs imposed on the system by the voluntarily uninsured.
The government's other defense is that the health-care market does not exhibit textbook competition. No market does. The economic features relied upon by the government—externalities, imperfect information, geographically distinct markets, etc.—are characteristic of many markets.
The presence of externalities and other market imperfections does not justify a departure from the normal rules of the constitutional road. Health care is typically consumed locally, and health-insurance markets themselves primarily operate within the states. The administration's attempt to fashion a singular, universal solution is not necessary to deal with the variegated issues arising in these markets. States have taken the lead in past reform efforts. They should be an integral part of improving the functioning of health-care and health-insurance markets.
http://online.wsj.com/article/SB10001424052702304459804577285991632128670.html?mod=opinion_newsreel

If what is driving health care costs and insurance disfuction is government, then you can bet that Obamacare will worsen the problems, not ameliorate them.  The fact that man cannot engineer a functional "health care system", which exceeds that which  might evolve over time without coercoion, has become so obvious to me, I forget that others still it may be done.

Starting points - remove the tax incentives associated with employer "provided" health care plans which are more pre-paid service plans than insurance.  Remove restrictions on cross-state-border plans.  Remove "mandates" which require providers to cover this, that or the other, according to the influence of rent seeking constituencies; instead, let folks buy what they need, which for most, is catastrophic coverage. 

Every federal and state intervention creates negative unintended consequences, which justify further interventions, etc, a classic reinforcing loop of government regulation, perverted incentives, and ineffective, inefficient, care. 

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