Flutterby™! : Huckabee bs. Moore 2007-07-12 16:40:00.767506+00

Huckabee bs. Moore

2007-07-12 16:40:00.767506+00 by ebradway 10 comments

Evidently Republican presidential hopeful and successful dieter, Michael Huckabee, has been lashing out at Michael "Sicko" Moore. Yesterday he said something along the lines of:

"Michael Moore is an example of why the health care system costs more in this country."

His implication is that overweight people have more illness and are thus a burden on the health care system. Fat jokes and soap-box preaching aside, it seems to me that most news outlets are missing Huckabee's real gaffe.

Simple economics of supply and demand support Huckabee's argument - more demand for health care causes an increase in price assuming a fixed supply. But is the problem on the demand side or the supply side?

Economics also teaches us that with increased demand can come greater efficiencies and lower cost. It would appear to me that the problem lies not on the demand side but on the supply side. People aren't benefiting from greater efficiencies in the health care system. Instead of trying to convince the huge numbers of the American populace to live healthier lifestyles, we need to convince the minority of Americans who are in the health industry to better convey cost-reductions from efficiency.

A great example is how the Soviet Union perfected Radial Keratotomy. Instead of buying glasses for the millions of Russians who needed them, they refined the RK process to the point that a technician, not an M.D., could do the procedure and then setup a massive program. Granted, I'm not encouraging everyone to have their cornea sliced by a Soviet tech...

So he says the problem is that we don't shop for the best price - we just let the third-party payer pick up the tab. Hmmmm...

I guess it'll work because people with critical illnesses will die in the process of "shopping around" and it's much cheaper to bury a body than do open-heart surgery!

Or, better yet, declare yourself as an undocumented member of the human race, and simply show up at the emergency room without any identification at all. The American taxpayer will pick up the tab for you (sorry, couldn't resist).

Seriously, I'll think through some of the other determinants surrounding this issue, such as the number of number of uneceswary procedures which are done each year.

I'm not gonna get too much into this discussion except to point out that it's the Republican who's complaining about those who take advantage of the collective system rather than proposing ways to make the system less collective. Thank you, Comrade Huckabee.

The biggest problem I see in the US health care system is the fact that it takes three people to arrange for two people to be paid.

After years of being totally against the government getting involved in our health care system I've finally realized that they already are to enough of an extent that market forces no longer work in health care the way they do in other industries. Government regulates who can work in the field (medical licensing), what drugs can be administered, how much and how often, what type of agreement can be entered into to pay for the services what can be done about people who can't pay...

Eric, the health care problem in America has lots of facets, but one of the major issues is a lack of a single focus for all the players on the "supply side" of the equation.

Patients/businesses don't want to pay huge dollars for health care, so they've turned to various HMO/PPO types of plans where the emphasis IS on mathematical, statistical "efficiency" and "standardization of care."

However, patients complain their physician spends almost no time with them, they feel hustled in and hustled out, and THEN the med the physician feels they need requires something called a "prior approval" from the insurance. They resent that their surgeries must be "day surgery" and any stay in the hospital must be "pre-certified" and can only last for the "standard" time period. They resent being told the physician must order one type of scan before insurance will pay for another type of scan which tells the physician more information or they must order one drug (and watch it fail) before they can order the drug they'd like to order.

Americans bristle that health care workers want to treat them "efficiently" because they feel their health care should be individualized..... and so, by the way, does their attorney, when their "efficient" and "standard" treatment overlooks some test or procedure or longer hospital stay or med the physician would LIKE to order, but can't without fighting the insurance company.

Most physicians WILL order those tests or procedures or whatever (whether it's for CYA reasons or altruistic reasons is often debatable,) but that extra step of "approvals" and "pre-certifications" BREAKS the efficiency model by requiring time, manpower, and professional review from BOTH the physician and insurer.... and that translates into added costs for the patient ON BOTH ENDS of the supply side.

Unless those factions of the supply side can make peace and trust each other, health care is not going to truly be efficient.

I haven't seen "Sicko" yet (I will), and don't completely know Huckabee's complete stance on healthcare (I want to), but ad ad hominem attacks on Moore's own physical health by Huckabee in the context of a debate fudamentally and classically weaken argument.

I am a strong proponent of preventative medicine and education, thereby reducing the number of $100K+ quadruple bypass surgeries performed each year.

Jeff, check the essay I linked to today, it contends that much of the risk differential, at least in private health care, is taken care of by wage disparities. Of course publicly funded healthcare has no such restriction.

I'm still trying to figure out what I think about healthcare policy. On the one hand I like the notion of free markets, on the other hand I see that public spending on healthcare per capita in the U.S. rivals most nations with socialized healthcare, and then we add the private spending on top of that and we far outstrip every other nation in per capita spending on healthcare.

So perhaps the real imbalance is that the U.S. is paying for the technological innovations and R&D in healthcare that every other country enjoys the fruits of.

#Comment Re: made: 2007-07-13 15:11:56.875885+00 by: jeff [edit history]

I'll try to find time over the weekend to read that essay Dan. I think we're seeing a combination of things; the cost of healthcare is a pretty complex issue.

I like your last proposition that other healthcare systems enjoy the fruits of R&D done in the U.S. That is certainly the case in many instances. Drug companies in the U.S. make HUGE profits here. (Ever go to Canada to buy drugs? I don't, but I know people who drive 500 miles to do so). And the fact that it takes three people to arrange for two people to be paid is also a real problem.

Topspin: Thank you! I appreciate that input and I know it comes from your direct experience.

Health care is amazingly complex and I'm not sure what the best answer is. Sometimes I think it might be for the FedGov to provide some kind of baseline health care and allow private industry to pick up the difference. The problem with that is so many people view health care as a right. That if they are dying, they should be afforded the most advanced care possible to save them. That baseline level of care might not quite provide it.

My gripe with health insurance is that it's an obvious middle-man that we are all paying for. Look at those big buildings in downtown Chattanooga with Unum and BlueCross on them. That's your health care dollars at work!

I often wonder "how much" of our overall health care funds do we use in the last year or two of our life? It's got to be a substantial amount.