15 July 2010

Free for some people just means they are not footing the bill ... maybe

I see the following in the New York times today:

Health Plans Must Provide Some Tests at No Cost

Published: July 14, 2010

WASHINGTON — The White House on Wednesday issued new rules requiring health insurance companies to provide free coverage for dozens of screenings, laboratory tests and other types of preventive care.

The new requirements promise significant benefits for consumers — if they take advantage of the services that should now be more readily available and affordable.

In general, the government said, Americans use preventive services at about half the rate recommended by doctors and public health experts.

The rules will eliminate co-payments, deductibles and other charges for blood pressure, diabetes and cholesterol tests; many cancer screenings; routine vaccinations; prenatal care; and regular wellness visits for infants and children. ...

I assume that the reporter no longer believes in the tooth fairy. The article is tailored as news, and placed in that section of the paper (Page A16) by the Times editors. It has a laundry list of wonderful tests and services that no 'right thinking' person can deny are useful and desired

But the suggestion is a 'promise [of new] significant benefits for consumers — if [only] they take advantage of the services' without a corresponding cost for getting there. No hint nor argument is made that such 'medical' services are unavailable for private purchase already

Indeed, at the end of the day, there is no support for the headline writers assertion of 'no cost' and the reporter is well willing to disregard the pesky question of how to pay for this largess. Clearly these tests are not free and when accounts are settled; these costs will either pass through in a rate base, or the provider will exit the market it cannot make money in, or the insurance market will wither and die as 'the government' provides an 'option' that picks up the tab ... . But the problem is -- 'the govenment' at whatever level likewise needs to get the money to pay for such happy healthiness, and from the very same pool of people 'benefitted'

It is not at all clear that the transaction friction of a single govenment payer works at all well, or that having no choice but 'insurance' through government once the private insurers die is a good thing at all. In watching the 'response' of the government to the oil spill in the Gulf, it is patently clear that government 'oversight' has slowed the response, as BP has become risk adverse to the (reasonable) prospect of being second-guessed at every turn, and so is seeking prior governmental approval before acting in the remediation. The ccase can be made that playing 'Mother may I?' has harmed the Gulf more than the prior approach

Do we really think that a central government single point of control is going to react as well and quickly as a local doctor on the scene, when Aunt Minnie is lying, dying under an oxygen tent and needs some immediate surgery? Under the current system, the doc knows that he'll get paid, perhaps only in part of what is billed as a 'list price' for a prodedure, but eventually from the present model

But that is the end game, anyway, right? Vote and mandate 'bread and circus entertainment' ... until the producers all surrender and act to stop being charged for 'free' benefits to the consumers

'The problem with socialism is that eventually you run out of the other peoples (willing to be robbed of their) money'