[posted by Matt]
Megan McArdle writes, of US vs. European health care systems:
Doing something moderately ordinary here is a hassle. Doing something extraordinary there is often not possible for the overwhelming majority of citizens, though that depends on what, and in what system.
Yeah…doing something extraordinary is “often not possible” for “the overwhelming majority of citizens” in the US either. Depends on what that “something extraordinary” is, because the overwhelming majority of people in the US really don’t have coverage that includes many of those “extraordinary” somethings.
I’m really not sure what Megan is talking about here and what evidence backs it up. My wife’s best childhood friend is currently on her third round of intensive arthroscopic knee surgery. Another friend’s wife is a 15-year leukemia survivor. My wife’s father broke his neck and had three vertebrae fused, and has been in various kinds of physiotherapy for related issues for 20-odd years. A close friend has two children with severe birth defects; one was expected to die within six months of birth but, with heart surgery as an infant and constant care, is now 5 and doing okay physically, though he’s severely mentally disabled. And the main difference I can see between all of these people and any similar cases in the US is that while most of the people I’ve mentioned above are of modest means — air traffic controller, nurse, anthropology grad student — none of them are bankrupt, and all of the medical decisions they’ve had to make have been strictly medical decisions, not financial ones.
Add: Going back, I see Megan is on even less firm ground in her earlier post on health care.
…as Ezra [Klein] points out, people in Germany and France are not dying in the streets. So centralization does work better on health care than it does in steel. But I’d argue that the difference is that Germany and France, unlike the Soviet Union, have companies which produce in American markets to provide them products.
On the issue we are discussing — the issue of health insurance — Germany and France do not have any “companies which produce in American markets to provide them products”. The insurance policies offered by NUTS or AON in the Netherlands, say, are completely unrelated to the policies they offer in the US. The US could disappear from the face of the earth tomorrow with no substantial impact on how German or French health insurance companies write their policies, and no sensible argument to the contrary can be made. What Megan means to argue is that medical treatment and care is only developed in the free US market. But the German and French markets for medical treatment and care are no less “free” than the US market. What’s different are the markets for insurance. And “innovation” in insurance is almost exactly equal to new ways of siphoning away more money from the insured, and has virtually no benefits for anyone but those employed in the insurance industry.
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