Monday, December 01, 2008

Mandatory insurance

Yesterday I heard an NPR article about how Massachusetts is coping with mandatory health insurance and the problems it's causing, primarily the lack of primary physicians.

This got me thinking, due in no small part to a book I've been reading lately, "More Sex is Safer Sex", which examines interesting topics from the point of view of an economist (supply and demand and putting the real cost on to the those that get the benefits).

It would seem to me that the problem isn't that health care is so expensive that no one can afford it and that people are going bankrupt trying to pay their medical bills and/or outrageous health insurance costs, but instead the problem is that there aren't enough doctors.

Some part of this equation is classic supply and demand, and Massachusetts' predicament shows it clearly, that there just aren't enough doctors. People with their new insurance are trying to use it, only to find that it takes them months (averaging about 4 months) to get to a primary care physician, and until that's done, they can't move forward in the health care system, so they continue to use emergency services and deal with the mess that creates.

If there were more doctors, presumably, they would be competing amongst themselves for quality and price, and driving down costs. If that was the case, then there might not be the need for insurance or complicated insurance forms that cost doctors money and all in all take 30% of every dollar spent on health care.

For every complicated problem there is a simple answer that is wrong, and this may very well be one of those answers, but I can't help but wonder if we're putting our attention in the wrong place. After all, how much use is insurance if you can't actually use it? I'd rather spend my money somewhere else.


Blogger Ian said...

Two thoughts:

1) It's possible that the mandatory insurance is actually causing the shortage of doctors in Mass. I don't know exactly how the rules there work, but with the government messing with the health care industry there, it's likely that they are in effect setting caps on the amounts that doctors can charge. If those caps are lower than can be gotten elsewhere (in neighboring states, say), then there's an incentive for doctors to pick up and move.

2) Part of the reason why healthcare costs more these days than it did, say, 20 years ago is just that there's a lot more of it you CAN get. New drugs, new diagnostic procedures, new medical techniques and technologies are constantly being invented. You're not just paying more for healthcare than 20 years ago, you're also getting more.


3:35 AM  

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