Thursday, March 22, 2007

Slouching Toward Socialized Medicine? Slouching Toward Socialized Medicine?

TCS Daily: Slouching Toward Socialized Medicine? points at the trend towards socializing our medical system. I find this esp. horrifying given my free market orientation. Of particular note:
That would be bad for erstwhile slackers of Generation X and Gen Next. It would be even worse for the rest of the country. That's because the slouch could easily become a straitjacket, for any move toward state-run healthcare will happen in the context of already exploding debt.

Even if they've already paid off their student loans (snicker) and have exactly no credit card debt (giggles giving way to loud gasps of laughter), X-ers and Nexters are already up to their eyeballs in debt for the big three entitlement programs - Social Security, Medicare and Medicaid.

Federal Reserve Board Chairman Ben Bernanke recently testified to Congress, "Expenditures for entitlement programs are projected to rise sharply over the next few decades." They're being driven by a combination of increasing life expectancies and decreasing fertility.

Spending on the big three currently amounts to more than 8 percent of America's GDP. That will rise to more than 10 percent in 2015; and to more than 15 percent in 2030, if projections by the Congressional Budget Office hold true. The percentage of Americans more than 65 years old is also expected to increase pretty dramatically too, from 12 percent of the U.S. population to 19 percent in 2030.

That puts the slouch towards socialized medicine in its proper context.

No one knows what a government-run health care system would cost. (John Edwards put the price of his universal care plan at $90 to $120 billion per year.) But it is almost certain to be far more expensive and far less efficient than advertised.
John Edwards can maybe be forgiven for his politcally driven optimism here. After all, this is someone who has made millions by driving up health care costs. But how do you control costs while disengaging supply even more from demand? Especially when there are always reasons to add new mandates?

We abandoned our no-fault insurance here in Colorado because in the end, the legislature had piled more and more mandates on the program. By the end, not only were Chiropractors being paid (at quite high rates), but so was aroma therapy. Of course, the obvious answer is to put ever stricter controls on payments for services. But that again ignores supply and demand, and as the pressure to keep down costs escalates, reasons for people to spend the decade or so after college becoming physicians will shrink. When I was in college, the best and the brightest went ot medical school. No more.

For those supporting this slouching towards socialized medicine, presumably in sympathy for those unable (or choosing not) to pay for their own healthcare, the inevitable reduction in quality and quantity of medical care will presumably not be of great concern. But I worry because in the next decade or so, I will likely be availing myself of socialized medicine (in the form of Medicare), and I frankly don't look forward to long lines and refusals for life saving procedures. And I worry about the pressure that this will all put on my offspring.


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