Tyler Cowen expresses an excess fear of managed health care; I actually don’t blame him as I have had some personal experience. I also agree with him on the Statement that Governments and Private Insurance will not be able to pay for all the medical care which people insist upon. Tyler being Tyler, and I being me; I know that We would disagree on Solutions to the problem. He would leave the Supply Side alone, only tinkering with the Demand for medical services. I would consider health care Supply as Profits-Optimizing enterprises inherently concerned with their bottom line. Tyler would add pressure to an already victimized Consumer, while I would make life unbearable to the medical Suppliers.
The whole rationale behind my objective policy would be to alter the power relationship where the Consumers have little effective impact on the market, in the face of Suppliers setting all the Rules and Procedures under which the market operates. I would simply utilize Government to change the matrix; a factor which I am sure will make Tyler howl, if he ever hears about it–remember he publishes within the NYTimes–which I don’t. My Readers ask How I would do this, and I will try to explain.
The first thing I would outline is Patient loads for Doctors; a situation where to maintain their license to treat Patients, they had to treat a certain number of Patients per year as set by Government regulation. It would change the nature of the market; forcing Doctors to accept a set number of Patients, no matter What their ability to pay. Medical Schools would be mandated to graduate a set number of Doctors per year, allowing for full Coverage of all medical Patients; failure to graduate this number of Doctors would lead to withdrawal of certification for the medical faculty. The level of proper medication for the total medical population would be determined, along with the Average medication deployment for each Doctor. A new Tax would be assessed on medical practice, with Doctors charged a tax on each proscribed issuance of a dosage of medication; something that could range in variance to amount like Personal Income, from maybe 15 Cents per Pill for normal issuance to maybe $3 per Pill or dosage for excessive proscriptions. There could also be a mandatory limitation of Doctor fees per Patient per year; I being Mean, and suggesting a limit of $1000 per Patient per year. I would grant Clinics an amount of no more than $3000 per Patient per year, and hospitals no more than $5000 per Patient per year. I would simply tell all health care Providers that they had to operate within their parameters, or lose their license to practice medicine anywhere under our Government’s jurisdiction. lgl