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Thursday, July 23, 2009

Myths of the health care debate

Cliff Asness of Stumbling On Truth has a long, but powerful common-sense refutation of many of the myths that we've heard over and over during this whole debate over health care reform. He starts off by answering the arguments about how health care costs so much more now than it used to.
Myth #1 Health Care Costs are Soaring

No, they are not. The amount we spend on health care has indeed risen, in absolute terms, after inflation, and as a percentage of our incomes and GDP. That does not mean costs are soaring.

You cannot judge the "cost" of something by simply what you spend. You must also judge what you get. I'm reasonably certain the cost of 1950's level health care has dropped in real terms over the last 60 years (and you can probably have a barber from the year 1500 bleed you for almost nothing nowadays). Of course, with 1950's health care, lots of things will kill you that 2009 health care would prevent. Also, your quality of life, in many instances, would be far worse, but you will have a little bit more change in your pocket as the price will be lower. Want to take the deal? In fact, nobody in the US really wants 1950's health care (or even 1990's health care). They just want to pay 1950 prices for 2009 health care. They want the latest pills, techniques, therapies, general genius discoveries, and highly skilled labor that would make today's health care seem like science fiction a few years ago. But alas, successful science fiction is expensive.

In the case of health care, the fact that we spend so much more on it now is largely a positive. The negative part is if some, or a lot, of that spending is wasteful. Of course, that is mostly the government's fault and is not what advocates of government control want you to focus upon. We spend so much more on health care, even relative to other advances, mostly because it is worth so much more to us. Similarly, we spend so much more on computers, compact discs, HDTV, and those wonderful one shot espresso makers that make it like having a barista in your own home. Interestingly, we also spend a ton more on these other items now than we did in 1950 because none of these existed in 1950 (well, you could have hired a skilled Italian man to live with you and make you coffee twice a day, so I guess that existed and the price has in fact come down; my bad, analogy shot). OK, you get the point. Health care today is a combination of stuff that has existed for a while and a set of entirely new things that look like (and really are) miracles from the lens of even a few years ago. We spend more on health care because it's better. Say it with me again, slowly - this is a good thing, not a bad thing.
He goes on to refute the arguments about Canadians paying less for medicine than we do by explaining the differences between the fixed costs of researching a new medicine and the variable costs of producing more pills. From there it's on to looking at costs in countries with socialized medicine and reminding us that the United States, by providing the economic benefits of medical research is, in a sense, subsidizing their health care. If they had to depend just on what it was profitable for innovators to develop in their own countries, they wouldn't have any access to all the wonderful developments we've seen in medical care in our lifetimes. And if we "reform" our system as the Democrats are proposing, we won't have anywhere to look to for providing the next generation's medical breakthroughs. And we will all pay in the cures not yet discovered.

Go read the rest of his essay and bookmark it for future reference when you hear these same arguments thrown up in debates again and again.

14 comments:

Skay said...

According to Bill Sammon this morning, taxes will go up for two years before the cost of nationalized health care begins.

That is how the Democrats and Obama can say that costs will not go up.

Pat Patterson said...

The problem with this particular argument, even when well thought out, is that it echoes the old stereotype about Republicans in that anything the Democrats propose is resisted either because of its inefficiencies or that Republicans can achieve the same thing but spend much less. That is basically surrendering the playing field to the Democrats and simply arguing over how many casualties we are supposed to take.

Much better to continue to reject this proposal based on the rights of the citizens to make their own choices in arranging for their health care and rejecting the proposal as being hostile to the whole moral concept of a free market without government control.

There may indeed be some statistical evidence that other systems might work slightly better but is slightly better enough of a justification for such a huge government endeavor. Do we really want to lose choices and spend a large amount of money for say charts that show we are living longer. The problem is that the US doesn't keep its health statistics the same as the Europeans or for that matter most of the rest of the world. We end up comparing apples and oranges.

It's easy to claim that France has a greater life expectancy until one finds that the infant mortality rates are gathered completely differently and that illegal aliens are not counted for any health measurement.

Bachbone said...

Unfortunately, facts don't matter to the people pushing agendas. For every bill (Bush and) Obama jammed through, ample evidence existed before the fact that it wouldn't work. The GOP is equally responsible (and reprehensible) for not having the guts to oppose most of them.

Freeven said...

You make a good point, Pat. One of the reasons I left the Republican party is that they have increasingly abandoned underlying principles and instead consumed themselves with finding more efficient and painless ways to shoot ourselves in the foot.

Coondawg said...

Unfortunately for the wingnuts here, rhetoric isn't refutation – although it's depressingly clear that rhetoric is all a wingnut needs when data such as these (http://www.nchc.org/facts/cost.shtm) don't serve the wingnut's partisan Republican purposes.

The American healthcare system rations healthcare based on the ability to pay, and the bar for access to care – i.e., the cost of healthcare – has been rising precipitously for the last decade or so. That's what the data show.

Suggesting that current costs are actually leveraging future medical benefits (which is one of the things Asness says in his article and the thing Betsy Newmark highlights) fails to acknowledge the disproportionate cost of American healthcare; the trajectory of healthcare cost; and the impact of cost upon those left below the bar to access... But none of that matters to the wingnut, who sweeps reality-based data under the rug (and compares healthcare cost to buying an espresso machine!), claiming that we're enjoying the "latest pills" and we're on our way to unimaginable medical breakthroughs (both of which only some citizens can enjoy).

The Asness article tells us nothing about healthcare cost but a great deal about the convoluted thinking that wingnuts desperately favor.

Ron K said...

Coondawg - too bad you reveal yourself to be worst than the "wingnuts" you claim reside on this site. that "fact" link you posted has no facts no source of data basically an empty site. it misrepresents opinion as facts.

tfhr said...

Coondawg,

Nice job on the link - it didn't function and neither does your argument.

Try a persuasive argument rather than hurling insults if you want to come here to make a point that supports your view that any, or even one, of the proposed health care "reform" plans are an improvement or actually viable.

You sound pretty silly when you claim to have facts, fail to enumerate them or expound in any on any of them, fail to cite any that effectively support your argument and the fail one more time in the simple task of posting a working link.

Try again and lay out the case for your stand on the issue.

If you would like an unbiased assessment of future health care costs as calculated by the Congressional Budget Office, something I believe we should all be familiar with, try taking a look at this quote from the CBO Director, Douglas Elmendorf:

"In the legislation that has been reported, we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount. And on the contrary, the legislation significantly expands the federal responsibility for health care costs."

Here is a functional link to his remarks before the Senate Budget Committee: http://www.freedomslighthouse.com/2009/07/cbo-director-directly-contradicts-obama.html

If that should fail for you too, then just go to www.freedomslighthouse.com

You can read or hear Elmendorf's comments for yourself or just let Democrat Senator Bill Nelson spell it out for you:

"'I think it's a devastating blow,' Nelson said of the import of the CBO analysis this week that the House healthcare reform proposal would worsen the fiscal situation of the U.S. over time".

"'The CBO is sort of an official umpire — they don't take sides,' Nelson said during an appearance on CNN Radio. 'And when they come out with a recommendation or a study, you know it doesn't have a political bent to it at all.'"
http://briefingroom.thehill.com/tag/congressional-budget-office/

See, that's a better argument than just screaming "Wingnut!" until you turn blue.

Coondawg said...

Hi Ron, I'm sorry your comment reveals you to be completely ignorant of how to access and evaluate information. Your ignorance is what happens when a wingnut, for example, relies unthinkingly (= stupidly) on the talking-points bequeathed upon them from above.

But, I’m not one who believes wingnuts aren’t trainable.

Ron, I'm going to instruct you in how to process information. Here's your first lesson, in which I tell you how to use one of the very simplest of tactics for gauging whether something you're reading is trustworthy. Ready? Look for the citations! You betcha.

The NCHC webpage I cited includes citations at the end of its article. I rate some of those citations higher than others, but in studying them, I'm persuaded that the article captures an accurate snapshot of the real world (one which contrasts sharply, in the forces that impact people’s lives, from the Republican world of a wingnut’s imagination and magical thinking).

Incidentally, by way of comparison, the Asness article includes zero citations. None at all. It does include a bunch of snarky footnotes at the end of it -- but I'm pretty sure even a wingnut can distinguish between snark and a referenceable entree to the relevant literature.

Dr Weevil said...

Maybe if you spelled the URL right, 'Coondawg', people would be able to follow it. (Hint: add a small L at the end.) Of course, a website that lists one of its honorary co-chairs as "Former President George Bush" without saying which Bush they mean is a website that has some difficulty getting basic facts right.

By the way, I think chances are roughly 2-1 that our least favorite troll has assumed a fourth pseudonym and is now posting as 'Coondawg' as well as 'Bill B.', 'Jawbone', and 'Master of Disaster'.

Coondawg said...

tfhr, you silly goose. My interest in this thread is addressing Asness’s article, which Betsy originally showcased and celebrated. The article itself is garbage, as I've shown, because its arguments reflect Republican magical thinking, rather than real-world data. On top of that, the article provides no citations whatsoever, which allows us to confidently identify it as propping up wingnut preferences and talking points.

The healthcare reality that Asness and Betsy Newmark want so desperately to debunk (if only they could!) is that American healthcare costs are out of line with the care provided.

tfhr, you're no better at addressing that reality -- and it's consequences for individuals and productivity -- than are Asness or Newmark. But keep trying. You show more promise than Ron does.

Oh, and the link works for me. You must have a browser issue.

equitus said...

I'm not so quick to lump them all together, Doc. I'm pretty sure Coondawg is a reincarnation of one of our regulars, but I see enough clues in their writings to differentiate them into at least 2 or 3 different individuals.

Anyway, CD doesn't really make any real points in his rants here other than to insult us, echo Axelrod talking points, and refer us to another site of questionable value. - rather than considering the ideas in the article Betsy linked. I found it very interesting, reframing the cost-value questions regarding health care, and how the libs' arguments of the last 40 years are becoming more and more obsolete.

But to address one of CD's themes, the "bar to entry" for health care. I agree that it's too high for that last 5% who are uninsured through no fault of their own. I blame that on over-regulation - the requirement that insurance policies cover wayyy more than is really necessary, pricing the coverage out of reach out for those few. But CD, the answer isn't to completely reinvent the US healthcare system into a centrally-controlled behemoth. THAT, my friend, is magical thinking.

Pat Patterson said...

Except the page, accurately addressed by Dr, Weevil, does not claim a list of citation but notes. Any jr high student knows proper footnoting will include pagination and not include press releases from companies that have a fiscal interest in a particular outcome.

How do you assess the seriousness of someone's argument when the facts of that argument are basically either nonexistent or simply talking points?

Ron K said...

Sorry Coondawg,

But you are the ignorate one, you can't tell the difference between information, data, and facts. I drilled down on some of the cite's within the site and then again on ones inbedded. the same result no facts, no source of data. opinions supported by opinions mean nothing.

tfhr said...

Coondawg,

Dr. Weevil, equitus, Pat Patterson and Ron K., have covered all the points I wanted to mention in response to your last comment to me.

I thought the issue here was about costs and that is why I cited Elmendorf's assessment. His non-partisan standing derails the usual mud slinging that erupts whenever a sacred cow is tipped. This time the claim that Obamacare will lower costs is proven to be inaccurate. That is the bottom line.