The wonders of technocracy

One of the interesting side shows to this steaming pile of an election has been the crisis of Obamacare. Per The Week Obamacare needs a massive influx of federal cash:

This week, the White House dropped a news bomb by acknowledging insurance premiums on ObamaCare’s exchanges will rise 25 percent in 2017. Those escalating premiums are already driving away customers, leading some insurers to pack up and leave the exchanges. As a result, one in five Americans on the exchanges next year will be in markets where only one insurer is offering coverage.

Great. I am sure President Clinton will be fully competent to handle the situation between naps and weaseling out of federal crimes.

This program was designed by America’s best and brightest Government Geniuses. The idea was to a) control health insurance costs and b) insure more sickly people. Seeing as how those are competing goals they had their work cut out for them.

The fact that, contrary to what the Geniuses think, health insurance is one thing, and health care – operations and medicine – is a different thing, and the problem is compounded. Cheaper health insurance doesn’t do much good if you can’t get medicine or operations with it. Anyone who promises to insure all Americans is probably selling snake-oil.

Now, there is a way to bring down the cost of expensive goods to the point that poorer people can afford them: you can make more of them, and make them more cheaply. That is what has happened with every other commercial good over the course of the 20th century. I drive a cheap 2006 Toyota that is a much better car than the Cadillac my dad payed out the nose for when I was little. My little great-nephews have tablets that an Arab Oil sheikh could not have bought twenty years ago, that an IBM executive 30 years ago could not have imagined. Some of this dynamic does go on with medicine, there is substantial medical progress going on, but little cost control.

I suspect (from my peanut gallery) that the problem is that healthcare is a consumer good but we think of it as a human right. While there are good reasons for that, there are plenty of other things that are human rights – like food – that we treat as pure consumer goods. No one has thought to have a government food department or employer based, government sponsored food insurance, yet we manage to eat.

(Worse, we don’t act as if healthcare is a consumer good, or as a human right, but as if it is a racket.)

Conclusion: I have no idea. I don’t know how to manage systems that complex. Unlike our Government Geniuses, I can at least admit the fact.

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6 comments

  1. Except a number of countries manage to have pretty decent universal healthcare.

    1. They didn’t overthink it. They said: everybody pays ten percent and we make no promises about the quality.
      In the U.S. they come up with a Rube Goldberg system to put alongside other expensive “systems” and say you’ll get the same quality.

      1. Regarding the quality, the best healthcare systems in the world happen to be in Europe with France as the number 1.
        Survival rates for diseases across the board are better in Western Europe than in North America.

      2. Meh. I’d have to drive down into the numbers to judge. Rating a “healthcare system” is actually pretty hard to do. It isn’t like a business where you have a clear bottom line, you have to cook up metrics and not everyone will agree on what those should be. You could be measuring cost, customer service, operation success, waiting times, etc. Aside from things like polio and cholera outbreaks, the health of the population is largely independent of hospitals or government offices, but a matter of cultural habits.

      3. The rating comes from the World Health Organization and counts the most important points of health care, from survival rates to early screening to life expectancy.
        In fact one of the reasons France scores best is precisely the preventive measures/screening aspect- as it’s the country that catches most diseases the earliest.
        So yes, we can measure, and the WHO is in a pretty good position to do so.
        The idea the American system is the *best in the world* is laughable. For one it’s not a system. It’s you get what you pay for. That means superb results for the wealthiest and perhaps nothing at all for a whole lot of people.

      4. But that is my point: if you are measuring life expectancy you are not really measuring your healthcare system, you are measuring your population’s eating habits, something completely unrelated to hospital administration.
        I’m not defending the American system, which you are correct is not really a system, but it is not a straight-up cash system, that would likely be much cheaper. There is so much regulation, insurance mandates, and government subsidies sloshing around that costs are completely distorted.

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