Tuesday, June 23, 2009

Health Care

The New Yorker had an article in which Atul Gawande attempts to explain the disparity in health care costs between McAllen and El Paso County, Texas. The culprit? "Defensive medicine." [Remember from Health Econ, Evelyne?!]

Anyway, here's an excerpt:
"...year after year, McAllen’s health costs have grown faster than any other market in the country, ultimately soaring by more than ten thousand dollars per person.

“Maybe the service is better here,” the cardiologist suggested. People can be seen faster and get their tests more readily, he said.

Others were skeptical. “I don’t think that explains the costs he’s talking about,” the general surgeon said.

“It’s malpractice,” a family physician who had practiced here for thirty-three years said.

“McAllen is legal hell,” the cardiologist agreed. Doctors order unnecessary tests just to protect themselves, he said. Everyone thought the lawyers here were worse than elsewhere.

That explanation puzzled me. Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?

“Practically to zero,” the cardiologist admitted.

“Come on,” the general surgeon finally said. “We all know these arguments are bullshit. There is overutilization here, pure and simple.” Doctors, he said, were racking up charges with extra tests, services, and procedures."

Things I've come across in the blogosphere:

Some people have argued that health care reform is necessary for the U.S. to maintain international competitiveness. Greg Mankiw, Paul Krugman, and the CBO think that's bullshit.

From the CBO: "Even though changes to the health care system could have various effects on the supply of labor, the underlying amount of labor supplied at any given level of compensation would hardly be affected by a change in the health care system. As a result, cash wages and other forms of compensation would have to rise by roughly the amount of the reduction in health benefits for firms to be able to attract the same number and types of workers."

In Health Care Overhaul, Language Matters - NYT

For Health Econ [great class, take it], my group presented on the Health Security Act [Hillary 1993]. We pointed out that President Obama was careful to avoid phrases like "universal." Instead, he opted for "accessible to all." I'm sure he didn't want to evoke such memories as these...

Mankiw thinks a public plan is a bad idea...

Alternative plans here.

Also, because we love him: How to Cure Health Care by Milton Friedman.

Random notes:
Evs, this reminded me of glorious nights spent as college seniors at the pub...

How much is one more year of life [of spending time with friends at the pub] worth? "A rough consensus from this literature is that an additional year of life is worth about $100,000 per year
(Viscusi, 1993; Tolley et al., 1994)" -Walking the Tightrope on Medicare Reform, David Cutler

Also, someone, play this with me.

1 comment:

  1. cant wait to hear the stories. must hear the stories. to know that we are not alone. i commented on the same post (on ymma) instead of here; read there to see why