Why National Med?

People offer many noble rationales for public education, but the data suggest they were adopted to create patriotic citizens for war. I suspect a similar data analysis could show why so many nations have recently adopted national medical systems:

Even as Americans debate … Obama’s healthcare law and its promise of guaranteed health coverage, … many far less affluent nations are moving in the opposite direction – to provide medical insurance to all nations.

China … is on track to .. cover more than 90 percent of the nation’s residents. … Two decades ago, many former communist countries … dismantled their universal health-care systems amid a drive to set up free-market economies. but popular demand for insurance protection has fueled an effort in nearly all these countries to rebuild their systems. Similar pressure is coming from the citizens of fast-growing nations int Asia and Latin America. …

Some countries have set up public systems like those in Great Britain and Canada. But many others are relying on a mix of government and commercial insurance, as in the United States. …

In countries such as India, politicians have learned that one of the surest says to secure votes is to promise better access to health care.  … The Thai system, set up a decade ago, has survived years of political upheaval and a military coup. “No party dares touch it.” …

Columbia’s universal system, set up in 1993, has cost more than twice what as expected.  (Today’s Post, article by Levey, p. A11; link will go here when available)

My guess: for our distant ancestors, medicine was a way to show that they care about each other. So today there is a demand for medicine to be provided by units of organization toward which we, or they, want us to feel solidarity. But I’m not sure what are the most direct and proximate causes of such a need for solidarity.

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  • Mark M

    Health care finance is a study in hypocrisy.

    Everyone seems to agree that health care is a basic right – hospitals cannot turn away the poor and uninsured. As a nation we feel they deserve to be treated, even if they can’t pay for it. Even though the law says everyone must be treated, the government won’t pay for that treatment. Rabid politicians wave their pitchforks and shout “Socialist!” at the monsters who suggest the government should pay for the things the government demands. As a result, the expenses are factored into the costs everyone else pays. When the uninsured have a life-threatening illness, such as cancer, they still get chemo, etc. Medicare and/or Medicaid comes into play.

    Obamacare side-steps the issue in an attempt to make sure as many people as possible can pay for it. This might reduce the issue (if the Supreme Court doesn’t strike it down) but does not address it head on.

    Since I’m not a hypocrite, I say we bite the bullet and do one of two things: (1) Decide, as a nation, that health care is a basic right and bake it into our constitution; or (2) decide, as a nation, that health care is not a basic right and strike down laws that require treatment for those who cannot pay.

    Although I’m normally a big believer in capitalism and paying your own way in life, I’m personally for #1. My reasoning is practical: We’re already nationalized! Medicare, medicaid, and jacked up prices (paid by insurance companies) already cover the expenses of the uninsured. We just pretend we’re not nationalized for political reasons. I’d simply prefer our solution to be more specific and transparent.

    I know the government would get it wrong, jacked up, and backwards, but I’d hope they’d straighten it out over time. Not that it matters. Nationalizing health care may be the right thing to do (or maybe not – I haven’t researched this a great deal and could change my mind based on new information), but it won’t happen as long as the cry of “Socialism” is an effective political tool.

    • Mark M

      I started reading and found myself saying the government won’t pay and following quickly with Medicare and Medicaid pay. Note that Medicare and Medicaid are not available to everyone, and many will not apply for them – the point is that some health care is already nationalized and other health care expenses are covered by higher prices for everyone else.

    • Captain Oblivious

      …the government TAXPAYERS should pay for the things the government VOTERS demand.

      There, fixed that for you!

      But seriously, can we please stop saying the “government” should pay for this or that? On any given issue, maybe it should be collectively financed and maybe not, but it’s always the taxpayers who actually pay, not the government. I find that substituting “taxpayers” instead “government” helps to clarify many issues.

    • My understanding is that the total costs from uncompensated emergency room care are actually a trivial fraction of healthcare costs.

  • wophugus

    Might nations be adopting nationalized healthcare because nationalized healthcare provides similar health outcomes with lower costs and psychological strain? Especially if you can free ride on the US for medical innovation?

    It seems weird, when there is a lot of evidence that something is a good idea on consequentialist grounds, to take as given that people are doing it for some recondite, irrational reason.

    • g

      It seems weird, when there is a lot of evidence that something is a good idea on consequentialist grounds, to take as given that people are doing it for some recondite, irrational reason.

      New here, are you?

  • Surely it’s reciprocal: organizations provide for individual needs, and individuals feel allegiance to organizations? Take the Amish, for example: they provide for their own health care. So one mark of allegiance to the group is contributing to the care of others; the contribution is both real and has meaning. If and when the group no longer provides such benefits the individual will no longer contribute.

  • V

    I’m now eagerly waiting for the post where Hanson will tell us that demand for property rights is just a form of signaling.

    • Anonymous

      V- Property rights obviously isn’t about signaling, but status. This does not, however, undermine the fact that for pragmatic reasons they are very useful.

  • Cyan

    Our distant ancestors were wired for face-to-face interaction. When I visit my doctor, I feel grateful and loyal to him, not to the faceless bureaucrats in Toronto who pay him.

  • ChristianK

    It makes no sense to say: “People offer many noble rationales for public education, but the data suggest they were adopted to create patriotic citizens for war. ”

    Just because the data suggest that some of the spending on public education is due to warfare doesn’t mean that all of the spending on public education is due to warfare.
    It’s not either-or.

    • This is simply not correct. If public education was to prepare for warfare, then Conservatives would be all for funding public education the way it funds the Military Industrial Complex.

      They wouldn’t be talking about eliminating the Department of Education.

  • Bill Wesley

    No expense is spared finding better ways to kill more people faster, our military budget is the greatest purely tax derived outlay in human history, yet many think not one tax dollar should go toward making people healthy. Two monopolistic cartels, the military and medicine, the first payed for to some degree by nearly everyone to their ability, the second denied to some degree to nearly everyone with a flat rate payment plan no matter what ones ability. The issue is not the affordability of insurance the issue is that medicine in general is over charging and under providing in nearly every way it can, because it can since it is a monopolistic cartel. People have a vastly overinflated view of medical care, A patients hospital survival chances rise the more poorly they are rated by their doctor, medicine has often shown to do MUCH harm, not a surprise in that purely profit driven medicine could do little else, its just as corrupt as purely profit driven religion would be.

  • Andrew

    Does anyone know the name of the health care study performed, perhaps in the 70’s, in which a group in the study was given access to unlimited health care?
    If I remember correctly the study may have demonstrated that an increase in spending by seeing more doctors and specialists did not have a significant impact on people’s health, but did cost a heck of a lot more than care for people who did not have unlimited access to health care.
    Thank you!

  • Andrew

    Awesome, thank you!