Ezra Klein’s Astonishing New Charts
Or at least they seem to have astonished Klein. Here’s one as an example:
My goodness. As Klein says:
There is a simple explanation for why American health care costs so much more than health care in any other country: because we pay so much more for each unit of care.
Anyone – what’s missing from this rather simplistic explanation?
What is the real cost of delivering the expected/desired/demanded health care during a doctor’s visit? What is the cost per “unit delivered”. And if it is higher, why is it higher? Is it higher simply because we’re being gouged as is implied by Klein? Or is more being delivered per unit and thus justifying the higher cost? The chart tells us none of that.
What will these various countries pay for during a visit? And given that, which country’s patients get the most (and best) care for the money? Again, the chart tells us none of that.
As has been pointed out any number of times, when you remove non-health care related deaths from this country’s life expectancy statistics, we are in better shape than anyone. In fact, when you get into the later years, survival rates among our elderly are unsurpassed by any system. That to me would say that we must be delivering something during those visits that the mere “price” doesn’t reflect.
But all folks like Klein ever seem to want to talk about is “price”. This may comes as a surprise to some, but price is determined by cost and competition. It’s not an arbitrary number. In fact, competition keeps both cost and price (and thus profit) at a reasonable level. That’s how a market works, even one as distorted by government intrusion as our health care system.
There’s also another 800 pound gorilla in the room. Actually the gorilla is the bar on the graph disguised as a $72 fee from Medicare. How do you think the difference between those paltry fees and the real cost of the visit are recovered? Look left, young man, look left. That big bar of private insurance subsidizes Medicare by absorbing the cost shifting which goes on from Medicare payments which don’t cover cost. Without the ability to do that fewer and fewer doctors would accept or treat Medicare patients. In fact, why do you think they limit them now? That reality, of course, isn’t reflected at all in the chart.
Additionally, there is the quality of care – what does a $30 doctor’s visit buy in Canada or the UK in comparison with a $72 Medicare visit in the US? We really have no idea. So how then is such a comparison relevant to anything? I can buy a KIA or I can buy a BMW. Few would argue they have the same cost and certainly not the same value. The quality is entirely different. Yet they’re both cars. The chart assumes all care is equal. But we know that isn’t true.
In fact, these sorts of apples and road apples comparisons aren’t useful for much more than gulling the masses when pushing an agenda. Surely, common sense tells us, we can get more for less, right? Of course not. Most people discover during their lifetime that you do indeed get what you pay for. And in the field of health care, the differences can be vast.
In terms of a serious argument for government run health care in a free country, the astonishing charts leave a lot more unsaid than said. Or put another way, they and the argument Klein tries to make with them aren’t worth the powder to blow them to hell.