Stumbling Toward a Market for Health Care in the U.K.

Many economists view the health-care bill passed in the U.S. earlier this year as falling somewhere between “a complete waste of time” and “actually making the situation worse.”

Will the Conservative Party do better with health-care reform in the U.K.? Delia Lloyd is cautiously optimistic that the proposed baby steps towards more market-based health care will improve the British system.

Even if the British health care reform fails, there seems to be a lot to like in the policies that David Cameron is pursuing.


Brett

I'm leaning towards "actually making the situation worse."

jblog

"Many economists view the health-care bill passed in the U.S. earlier this year as falling somewhere between 'a complete waste of time' and 'actually making the situation worse.'"

So wait -- is that hope, or change?

Aron Boros

It would be helpful if you provided links to the "many economists" who believe that the health care bill is either of the things you suggest. Or to detail along which measures it falls short.

At a minimum, the law is projected to result in millions of Americans getting health insurance. More optimistically, there are components of the bill that may result in meaningful Medicare reform, and somewhat decreased tax-based distortion of health benefits.

There's also the possibility that the individual mandate and the exchanges will make the health insurance market work substantially better than it currently does, at least for individuals and small businesses. Like all insurance markets, health insurance is subject to adverse selection. The individual mandate is a huge step to address this problem.

Please link back to any prior posts you have with this kind of discussion that I may have missed.

Thanks,
Aron

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frankenduf

i agree with Aron Boros- the opening paragraph of this post sounds like an 8 year old essay on the topic- anyway, the UK doesn't have to do "better" than us, cuz were already behind them, in terms of cost containment

David

I like Levitt's writings and way of thinking about the world, but the first sentence of this post was both lazy and misleading. First, as another commenter already noted, Levitt should have included some cites (links) with the sentence. Second, "many" is not "most" - I could also accurately write the following sentence: "Many economists view the health-care bill passed in the U.S. earlier this year as falling somewhere between 'a signficant advancement' and 'a small push forward.'"

Indeed, the Obama health care proposal was originally developed by an economist (somebody Prof Levitt likely took a class from in graduate school!).

William

It would be helpful if you provided links to the "many economists" who believe that the health care bill is either of the things you suggest. Or to detail along which measures it falls short.

Seriously. "Many economists" wouldn't even cut it on Wikipedia.

Matt

"Many economists view the health-care bill passed in the U.S. earlier this year as falling somewhere between 'a complete waste of time' and 'actually making the situation worse.'"

Assuming "many" refers to a fixed number, it seems plausible that someone could also write "Many economists view the health-care bill passed in the U.S. earlier this year as falling somewhere between 'totally awesome' and 'mildly helpful.'" Both of these statements are meaningless in practice except to identify the political leanings of the author.

The biases of the main authors of this site were always on the periphery, but recently they've begun to come to the forefront. Between the global warming "solutions" ridiculousness, hosting Rajan's public fight with Krugman, and now the quote above, it seems clear to me that this blog is no longer worth reading due to the obvious partiality exhibited by these authors.

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Gabriel

Um, many economists also supported health care reform.

Serolf Divad

"Many economists view the health-care bill passed in the U.S. earlier this year..."

This phrase reminds me of Weekly World News articles that began: "Top Scientists Predict Zombie Apocalypse Soon."

The simple fact is, if nothing is done to curb health care costs the U.S. will be bankrupted within a few decades. The Democratic Health Care proposals are modelled after ideas that were birthed in conservative think-tanks like the American Enterprise Institute in the 1990s. These are hard nosed, pro-market plans with minimal government control/intervention. It's not because it's the most effective way to expand coverage and lower costs, but because it's the only politically viable option given the powerful economic interests allied against any form of health care reform. There is a lot of money to be made from bankrupting America, after all, the people who are bankrupting us are making a killing doing so. Health Care reform is aimed at curtailing that future. Sadly it's a very steep, uphill battle.

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howlless

Actually, we should all commend Stephen for cleverly placing such a blatant obfuscation ("Many economists! MANY!") up front, distracting us from his more severe obfuscation in the body of the post.

Namely, his bold supposition that there is something drastically wrong with the British health care system and conservatives will... ahem... "fix" it.

The Brits have universal, guaranteed health care. If Stephen can cite ANY data showing the Brits want to give that up, please feel free.

Christophe

It's easy when other people pay for it

Unsympathetic

Did those "many economists" also point out to you that the health care bill was a copy of the Heritage Foundation's work in Massachusetts? Yes, The Heritage Foundation.. the Republican think-tank, not a Democratic one. Unfortunately for those of us who are interested in fact rather than inaccurate Republican talking points, the health care bill was a precise copy of the same one that's been the law of Massachusetts for years.

Despite the vague assertions and unproven allegations of Fox News - excuse me, the Republican Party - the bill as passed was the BEST you could have possibly achieved while still keeping private health insurance alive. Democrats, you see, actually bother with making their bills deficit-neutral. Did your "many economists" remind you that the single main reason health care is bankrupting the US is Bush's unfunded Medicare Part D - which cost over $850 billion, the single largest bill to date in the history of the country?

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jonathan

The UK has universal coverage, something Delia clearly points out, while the only proposals for the US other than the political compromise, mostly GOP created Obama reform would have done zero to cover more people. The GOP plan, per the CBO, would have covered a smaller proportion of the population in 2020.

Cameron is wholly committed to maintaining the UK system while introducing efficiency reforms. If he changes that position, he will be voted out. The Tories know that.

You carp about the Obama reform but offer nothing as an alternative other than continuing the high cost, low coverage system that puts tremendous risk on individuals and families unlucky enough to have illnesses or conditions.

To play a card, you had this in your family. Imagine living with that without your University benefits, unable to get coverage for your child, unable to afford the care. That matters in the UK but apparently not to much of the US and, it appears, not to you.

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Jon

I agree with the largely universally appalled responses to Levitt's opening sentence in these comments. Its obviously only one sentence so I won't get too worked up about it, but just a really callous comment by Levitt. I hope he was merely trying to juxtapose the US debate with the humorously opposite debate happening in the UK, but even an economist can appreciate how bad the healthcare system is prior to the reform law and how very important aspects (# of uninsured, being dropped or denied by insurance companies) are at least being addressed in a significant way, if probably not solved.

Hitek

The United Kingdom providing it's "needy" citizens with the necessities required for life has led to generations of families that no longer intend on doing a very single day of work in their whole lives, so that a large portion of the population is completely supporting a smaller portion of the population, and it only seems to be getting worse and worse. Google "Council Houses".

Giving "children" what they want without *forcing* them to work for it tends to lead to spoiled and expectant "children". This is human nature. Those who are able must be forced to work for what they get in life, so that generations of dependent people will not proliferate here(more than they already have because of our pre-existing social policies), as they have in the UK...

Y

Yeah, maybe they'll change the system in the UK so that people stop living longer than we do in the US. Bet the British people can't wait for that.

http://blogs.ngm.com/blog_central/2009/12/the-cost-of-care.html

Griff

As a Brit, I'm happy with the NHS and free health care.

Which is a completely separate thing from welfare benefits.

The US and UK are starting from such fundamenatally different points on health care that I don't believe any citation of reform on one has any bearing on the other.

Paul

Healthcare reform....or healthcare insurance reform? When does the quality of our healthcare improve?

Let's see if the UK can do a better job of addressing the root cause rather than throwing more bodies at a broken system.

ruralcounsel

#4
Factor out deaths due to shootings (e.g. gang/drug related) and the vehicular accidents due to the extra miles we drive because living in a larger, more mobile country, and our national life expectancies aren't that different.

I don't know anyone who'd exchange our current healthcare system for the UK's NHS outrageous waiting lists, purely on the basis of cost. Nothing provided by government is "free", it just means someone else is probably paying for most of your share of it.

#3 and #6:
But it works for "the majority of climate scientists"!

orthodoc

Well, if you believe that the fundamental problem with health care in this country pre-Obamacare was that there wasn't enough bureaucracy and paperwork, and that patients weren't insulated enough financially from their care, then yes, Obamacare is the answer.

The primary result of Obamacare will be to dump millions into Medicaid-like programs. Yes, they'll have insurance, but there will be no providers to accept it. And no matter how hard the government smacks providers around, it can't avoid the fact that forcing us to provide care for less than cost will be untenable.

Good, cheap, available. Pick two.