The Rape of the Innocents

There are always those Individuals who manage to confuse with clarity. Alex Tabarrok is just such a One. Study of this Post can accent this fact. No one has ever adequately defined a Quality Adjusted Life Year (QALY) because the definition is either too limited or too extended. Is there quality of life if two months of the year is spent in intense medical treatment? How much ambulatory capacity must there be to ensure quality of life? Is quality of life assured if an individual cannot escape a debilitating medical condition within the year? Still, there must be some measurement associated with life expectancy. Here again there is a problem, as it cannot truly be aggregated, but must be extracted from the projected Death rates and medical costs not segregated between longevity and maintenance values. Alex makes the truly accurate observation that We spend way too much on medical care, and gives a poor-grade, but effective, means to quantify the over-expenditure.

I would approach the Problem from a different prospective. I would examine those Countries with lower expenditure but longer life outcomes, and chose the lowest component Cost for each sector of medical treatment. It is the aggregate of these specific Costs which I would have the Government guarantee, and leave the rest of medical financing to the individual Patient. Government need not provision American citizens with greater medical care than exists elsewhere, Americans would find it far easier to determine what level of medical care they can truly afford, and medical providers would not be given a blank Signed Check as they are today. It could be a solution to our medical problems, or it may only be my desire to witness a Doctor file for Bankruptcy just once. In any case, there would be a real effort expended to contain the health care Costs in America.

Both Greg Mankiw and Don Boudreaux think this article from the grave by Milton Friedman is worth re-reading, so I will pass along the link. I do not disagree with Uncle Milton about the horrors of Third-Party payment, or the fact that medical insurance is nothing more than a Savings Account inefficiently run. I will even stand with him in thinking that the bureaucracy of Government involvement in the Issue has vastly increased the total Cost paid. I agree here with Friedman:

the increase in longevity did not have any systematic relation to spending on medical care as a fraction of income.

The actual fact is better Housing, Food, and easier Working Conditions had far more impact, than has Doctors, MRIs, or Drugs. The worst Welfare in the system is how medical Providers boosted their Charges by venue of superior ancillary Lifestyle. It is the worst Welfare boon since the confusion of Tax law granted Tax Accountants their huge bonus. lgl