Economic Understanding is one of the key dimensions, but
what is so important about it? I have
given several examples over the years showing how people make poor decisions
when they fail to connect outside spending with their own financial
welfare: insurance claims raising the
cost of insurance for everyone, legal settlements driving up the prices we pay,
shoplifting affecting honest shoppers, businesses passing along the cost of
government regulations, etc.
Another side of economic understanding is being able to
predict unintended consequences of artificial interference in the normal course
of business. I have written several
times about more insurance not being the answer to high medical costs, whether
it be the current plan or some alternative.
(See April 16, 2012, September 10, 2012, February 22, 2013, October 28, 2013) This prediction continues to come
true.
A recent Huffington Post article tells of the impending
doctor shortage. How do you add millions
of people to patient roles (by providing them with subsidized insurance) without
adding more primary care physicians?
Doctors’ time doesn’t magically expand; new doctors don’t magically
appear. They must be trained and
hired. “According to the Association of
American Medical Colleges (AAMC), unless something changes rapidly, there will
be a shortage of 45,000 primary care doctors in the United States (as well as a
shortfall of 46,000 specialists) by 2020.”
Using our economic understanding we can predict that hospitals
will be bidding for those few doctors which will drive their costs up. Patients will be forced to “pay” through
extended waiting times or searching among the dwindling number of doctors who are accepting new
patients. “Many primary care doctors and
dentists do not accept Medicaid patients because of low reimbursement rates,
and many of the newly insured will be covered through Medicaid. Many
psychiatrists refuse to accept insurance at all.”
On the surface the proposals look so enticing: Insurance for everyone must be a good thing, caring
and compassionate. In the richest
country in the world, why doesn’t everyone have access to quality health
care? The argument is compelling, but
economic reality provides a brutal wake-up call. Notice what happened about ten years after
the government decided to make home ownership, “the American Dream,” available to more families. Notice that college prices continued
to climb even after the introduction of grants and “subsidized” loans – leaving graduates today with $29,000 debts. It was
not until colleges saw a reduction of state support and viable competition from
tech schools and especially on-line courses, in other words real economic
pressures, that they felt a need to drive down tuition costs. The well-meaning proposals and programs often have the opposite effect.
If politicians and the voters they appeal to had a better
economic understanding, some of these decisions, innocent and caring as they may appear, might
have been questioned based on predictable negative consequences.
No comments:
Post a Comment
Click again on the title to add a comment