Here’s a thought experiment:
New universal health care plan:
The government will pay in full for any medical treatment for any American who wants it, if that treatment was available 50 years ago.
If you don’t want rich people getting subsidized aspirin, go ahead and add a means test. I’m just trying to keep it simple. This is a thought experiment, after all, and a thought experiment aimed at liberals, so I’m just trying to keep it simple.
One of the strongest arguments against socialized medicine is that it will destroy or at least retard medical innovation. The above proposal neatly solves that problem.
In terms of the economic dynamics, health care innovation is very much like the development of flat screen TVs. 10 years ago, a 40″ Pioneer was $50,000 and it was way less sophisticated than the similar model available for $800 today. Really rich people paid the R & D cost for plasmas, and now we can all have flat screen TVs with better technologies (like LCD).
What would have happened if the government had tried to guarantee that everyone got a plasma TV the first year they came out? Either they wouldd have bankrupted the country handling out those TVs, or would have had to ration, or would have had to force Pioneer to accept much less money for them (in which case Pioneer would have said, screw this, and we’d be watching 32″ CRTs still). Hmmm… to me that sounds much like the health care choices being offered by the government right now.
RESOLVED: All other things being equal, it is better that fewer people suffer or die of causes that are medically preventable, not just now but going forward to some point in the future. A medical system that covers everyone but causes 100,000 people a year to suffer or die of preventable causes every year for the next 50 years is worse than a medical system that allows 500,000 people to die this year, and 250,000 the next year and 125,000 the next year, and so on.
I’m assuming that medical innovation is the most important factor in how good medical care is. Like in how good TVs are. And I’m quite willing for some people to die now who can’t afford the latest and greatest medical care in order that in the relatively near future many more people will be saved because of innovation and the cost and benefit of R & D for innovation being borne by the rich. This is exactly like poor people not being able to afford a first generation plasma TV, except that the poor person didn’t die from not having a TV, and will die from not having access to the latest and greatest medical care.
So you have to get really cold and rational, Spock-like, and look at the needs of the many in the future outweighing the needs of the few in the present, and realize that this person who will die now because they can’t afford a medical innovation would have died anyway had we stifled medical innovation 20 years ago. This present person would have been one of those future persons who wouldn’t get a treatment.
The same incentives that improve TVs improve medical care. Innovators will no more produce better medical care than they will TVs if not given the same kind of economic incentives. It would be really nice if medical innovators were so driven by the desire to save lives that they would keep innovating for free, but that’s not how it works.
Now you may disagree with me about the value of medical innovation. In that case, you should have no problem with my modest proposal to cover everyone at 50 years ago state of the art. That would be really cheap too.
The real reason that medical costs are rising is because medical innovation is accelerating incredibly. TVs are more expensive these days too than they were 20 years ago. It’s because they’re so much better. The reason the government is so worried about medical costs is they’ve stupidly bought into funding all this new capability for everyone. Like they’ve noticed TVs are getting better and have agreed that every American deserves the best new TV money can buy, during its R&D phase.
One of my best friends in my life had stage 4 lymphoma and now has no detectable cancer. It was several years of touch and go and experimental expensive treatments. Had this happened in 1980, he’d be dead now. The richest man in the world in 1980 couldn’t have bought survival for a billion dollars. My friend got his life ransomed for a quarter of a million.
Health care will be rationed. It already is, which is why people are so pissed off. The only question is, will it be rationed like plasma TVs, so that the rich get a jump but the poor get it all 10 years later, or will it be rationed in such a way where all the money to be made is in the black market and in bribing officials into letting you jump the line? Or will the rationing system continue to support relentless, ruthless innovation?
If you fall for Obamacare, you deserve to die. But you’ll get away with it, mostly, and your grandchildren will die, even though they could have been saved if you hadn’t been such an envious, panicked, greedy fuckstick.