From: dean@vexcel.com (Dean Alaska)
Newsgroups: alt.activism.d
Subject: Re: The Decline of America: Health Care
Date: 28 Sep 92 20:19:17 GMT
Organization: VEXCEL Corporation, Boulder CO

In article <Lvz-CbB@engin.umich.edu> jwh@citi.umich.edu writes:
>In article <1992Sep25.155621.22855@vexcel.com>, dean@vexcel.com (Dean Alaska) writes:
>|> >
>|> Although this particular study said that govt intervention didn't help
>|> or hurt, it didn't figure out (or at least didn't say) what does cause
>|> the big differences in health statistics.  Until these factors are
>|> spelled out, the question is open.  The study is either hiding something
>|> or overlooking something.  Until that something is discovered, we can't
>|> assume that its initial conclusions are complete or accurate.  They
>|> could simply have overlooked an important factor.
>
>Here are some excerpts from the conclusion section of the paper:
>
>"Perhaps government can indirectly improve the performance of the
>health care sector by creating an environment that allows the 
>macroeconomy to function properly.  Our results indicate that
>infant mortality is greatly influenced by higher levels of real
>GDP. [...]

Correlation to GDP makes sense ot me but isn't the per capita US GPS
already higher than other countries with better health care metrics?
>
>[...] Our empirical study also finds that more abundant medical
>services cause infant mortality to decline by a substantial
>percentage.  Certainly, the government should not adopt regulations
>that negatively affect the quantity and quality of medical inputs.
>Some health economists view the diagnosis related groups system and
>relative value scale scheme as regulations of that kind.

Unfortunately I don't know what "diagnosis related groups system"
or "relative value scale scheme" refer to.  The term "some health
economists" indicates a lot of uncertainty here.
>
>[...]
>
>Of course, more studies are needed before any empirical generalizations
>can be made and policy implications can be safely drawn. [...]"

There will allways be rrom for studies.
>
>While it is true that we can't rule out the notion that the initial
>conclusions are complete or accurate, it does raise a red flag.
>Given the track record of other U.S. government programs, given the
>fact that a national health care program such as NHI would give
>government greatly increased control over health care options and
>given the probability that the system wouldn't improve health care
>or reduce costs, I prefer to look at some other alternatives.  Alternatives
>which are more in keeping with individual freedom and reduced
>government interference.
>
I am not much of a fan of pay or play and I think Clinton's NHI is similar,
althougn I'm not sure exactly what the differences are.  I believe that
a single payer system would be better.  Such a system gives individuals
much more control over their health care choices than most HMO's do
now.  The track record of US payer programs such as Blue Cross/Shield
and Medicare indicate that they are more efficient _as insurers_ than
is the private insurance industry.  Single payer has some cost control
factors although others are needed.  An emphasis on preventive care
would go a long ways to controlling costs - eventually.  The Oregon
plan does that.  My utopian health care system also would not involve
the government at all, but we don't live in utopia.  Non-profit
hospitals would be part of it since the current system emphasizes
high-tech goodies, that while needed, are so oversupplied that their
under-utilization requires subsidization from other components of the
health care system.  A pure market approach has the problem that
consumers do not approach health care purchasing decisions as they
do the purchase of a tv.  People don't tend to bargain hunt after
a car accident nor when they need an operation and the current
system takes advantage of that.  The bottom line with a market approach
to anything is that it doesn't allocate well when what it is providing 
is a basic necessity _and_ the cost of the necessity is very high.

The health care crisis in the US is such that we can't wait years
for more studies.  If you have alternative suggestions, I am
willing to debate them.  If they are of the laissez faire variety,
they would need to deal with the problems I mentioned above.

>
>James W. Howe                  internet: jwh@citi.umich.edu
>University of Michigan             uucp: uunet!mailrus!citi.umich.edu!jwh
>Ann Arbor, MI   48103-4943         


-- 

		dingo in boulder	(dean@vexcel.com)
Newsgroups: alt.activism.d