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Monday, October 29, 2007

Is more "responsibility" and "choice" the health care answer?

by folkbum

John Torinus, corporate muckity-muck and business columnist for the Milwaukee Journal Sentinel, can barely set keys to keyboard without touting expanded consumer "choice" as at least a significant part of a health care reform plan that he would back. He does it again Sunday:
[U]nderlying medical costs are the primary issue, not access and who pays. As costs escalate, access disappears. If the mandated insurance [in his preferred reform plan] includes high deductibles, co-insurance, personal health accounts and proactive health management, costs will stabilize as policy holders take responsibility for their health and health costs.
The problem with health care, he repeatedly asserts, is that consumers have too much of it, spend too much on it. The more we empower consumers (and force them, through their pocketbooks) to be empowered, then they will spend less and costs will fall.

Someone needs to slip Torinus a copy of WPRI study of "choice" in Milwaukee schools that I wrote about last week. That study suggested that despite a multiplicity of educational options and a wealth of performance data available about the Milwaukee Public Schools, few parents bothered to make decisions about where to send their children to school based on those data.

Someone should also remind Torinus about all the great decisions homebuyers made over the last few years, with all the options and information available to them, they still chose ARMs and other risky loans and now we face record foreclosures. (We bought our house before the peak of the bubble; we saw what was out there and, thankfully, made a much wiser choice.)

I'm sure that it won't take much to come up with more examples of failures of the market in this way*, and, as more sensible conservative Rick Esenberg noted last week, health care is a different animal entirely: If a consumer makes a bad choice, we just can't let them get sick and die anyway. Lose your house? Hock the jewelry? Fall into a debt spiral with check-cashing joints? No problem (though I support the efforts to make the latter less likely). But die? Is that the America we want to be?

I don't think Torinus is heartless; I think he simply puts too much faith in markets in which success will prove elusive.

* Or, for that matter, market "successes" that are really dependent on government subsidy and interference. As fiercely as many conservatives and Republicans defend the market, they are usually more than willing to bend over backward to privilege their donors. Insurance companies come to mind.

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