taxwonk |
05-03-2005 06:29 PM |
Putting aside Judicial nominations and steroids
Quote:
Originally posted by Mmmm, Burger (C.J.)
That's not really market failure, that's non-market/regulatory failure. That's been created by a belief that health care should not operate within a normal market. Instead, people should get health care through employers, free or at low cost, and should not bear much or any of the actual costs they impose on the system.
Yes, the health care system is fucked up for a variety of reasons, but you can't claim it's market failure when the current structure is far from any kind of "market" as we usually understand the term.
The moral question is the fundamental one--should health care be allocated in a way other than the market. If so, how do you design a regulatory regime to implement best whatever allocation you want, while also minimizing waste and unfairness. But the justification for doing that is not because the "market" failed--it's because you don't "like" the result the market would reach.* To the contrary, the US has the best health care because it has, to the greatest degree of any developed country, actually let a true market remain to a fair degree.
*contrast, e.g., a market failure like pollution--there there is not a market in the cost of pollution, and there's a collective action problem in limiting it, so one can say it's market failure that we need to cure, not merely impose a moral view of how much pollution should be permitted.
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I have two thoughts, which I will express briefly. First, you say that the health care market is not an example of market failure, but of non-market/regulatory failure, because a true market doesn't exist. We agree on the state of the market -- there isn't one. Isn't that the most extreme kind of market failure?
Second, you suggest that the moral issue is whether health care should be allocated in a way other than the market? I would be inclined to respond that yes, it should. Basic health care should be available to all people, at a price consistent with the true cost of the service provided.
What this means is that the hospital can't charge $3000/night for a stay in a semi-private room to the patient in for pneumonia, because the room price has to subsidize the cost of the MRI machine. No $3.50 aspirin to help defray the cost of a clinical trial for a drug which the pharmaceutical company is charging $10,000/month per patient.
The cost of basic health care should be within everybody's means. And the government should provide ransfer payments for those who can't afford it.
I would start there, and then I would try to tackle an ethical way to deal with high-cost treatments.
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