Friday, December 4, 2009

Dean Baker’s “practical” solution to health reform…

In railing against an entitlements reform commission, Dean Baker writes:

serious people would focus on fixing the country's health care system, but the Peterson crew focuses on cutting Medicare. One obvious way to both cut Medicare costs and start to get U.S. health care costs under control would be to allow beneficiaries to buy into more efficient foreign health care systems, but the Peterson crew doesn't seem interested in proposals that don't cut benefits for working people.

Okayyyy… Look, Dean's argument that people would be better off under foreign health care plans is a good one – I'm not one who hides behind the "America has the best health care system in the world" talking point. (Best quality? Probably – when you throw massive amounts of money at a problem it's hard not to get something back in exchange. But best quality for the price? I'm not at all sure about that.)

But does Dean really think we'll get very far asking the Canadians, Brits, etc. to take over our health coverage? Leaving aside travel costs and adverse selection, those systems have problems of their own and I doubt they're looking to solve ours. But if Dean thinks this is the way to go maybe he should contact their embassies and see what they think.


Dean Baker said...

Hi Andrew,

the deal is that we will pay Canada, Germany and the rest. The gaps in costs are so large that even if we paid them a 10 or 20 percent premium over their own costs, then we would still come out way ahead, even after taking into account the cost of travel. It's simple arithmetic -- do the calculations yourself.

Thanks for the mention.



Andrew G. Biggs said...

Dean --

I'm not disputing the cost difference. And I'm not even disputing that it might be a good deal. (Would I take UK-level treatment at US costs? No way. Would I take it at UK costs? Maybe...)

The point is that this isn't a particularly practical solution. Do we send folks up north for a checkup? Lacking mandatory participation, how do we keep people from gaming the system? In other words, it's a neat analogy but I'm not sure I'd put off health reform while we wait to cut a deal with the Canadians.

JG said...

Hey, Dean:

How about dropping the ban on inter-state purchases of health insurance, so we New Yorkers could tap into the huge number of policies that are available to persons in other states that are available at a fraction of the price we have to pay.

Enabling us to escape the cartel imposed by the NY health workers unions, politicians, and few politically favored insurers that
drive our prices up so.

I mean, if you favor us purchasing insurance from other countries, how can you not favor making it legal to purchase insurance from other states?

More to the point, maybe, if the state cartels (driven overwhelmingly by Democratic unions and Democratic local politicians) won't allow inter-state purchases, how are you going to get them to allow purchases from other nations?

If you don't address first things first like that, you risk coming across as being not particularly serious about the cost problem, or anything else.