Uber for health care?

Insight into Health-Care Supply and the Price of Health-Care

‘For over a century, we've regarded health care as qualitatively different from other goods and services – an economic Oz, where the normal rules of nature don't apply. In doing so, we waste resources, keep prices artificially high and delay life-saving and life-improving technologies. But this will soon pass.’

‘In December, Dr. Naoki Ikegami told The New York Times: "[T]he U.S. health care system … defies the laws of economics, and of gravity. Once the price is high, it just stays there."’

‘Prices don't fall because we spend resources (via regulations, subsidies, cartels) to combat downward pressure.’

‘And yet, following the 1910 Flexner Report when health care was not much better than a coin toss, America feverishly paralyzed nascent medical markets. Medical school curriculum became rigidly standardized and for-profit schools were banished until 2007. Medical licensing emerged as medieval guild, giving doctors exclusive domain over work formerly performed by nurses and others. Laws forbade doctors from working for nondoctors. Blue Cross reinvented health insurance to serve hospitals more than patients. The Food and Drug Administration and other agencies relentlessly broadened control over products and services. Given medicine's primitive state during this period, the strictures laid down were more faith and ideology than science and economics.’

‘Over a half-century later, Arrow's "Uncertainty and the Welfare Economics of Health Care" became the proof text of "health care is different." Arrow enumerated the differences: domination by nonprofits, insurers as intermediaries, consumer ignorance and so forth. His essay was brilliant and correctly described the artificial world constructed over the previous several generations.

Thus, health care markets were hamstrung before useful medicine appeared, and the hamstringing continues today. As David Goldhill, author of " Catastrophic Care: Why Everything We Think We Know About Health Care Is Wrong," has put it: "[H]ealth care is indeed different ... but primarily because we insist on treating it as different."‘ - Defying Gravity, Robert F. Graboyes, US News and World Report, 06/12/2015

Link to the entire article appears below:

http://www.usnews.com/opinion/blogs/policy-dose/2015/06/12/why-us-health-care-is-so-expensive

The Health-care Supply Side: Certificate-of-Need and Restrictions Upon Supply

“Thirty-six states and the District of Columbia currently limit entry or expansion of health care facilities through certificate-of-need (CON) programs.¹ These programs prohibit health care providers from entering new markets or making changes to their existing capacity without first gaining the approval of state regulators. Since 1973, Florida has been among the states that restrict the supply of health care in this way, with 11 devices and services—ranging from acute hospital beds to organ transplants to psychiatric services—requiring a certificate of need from the state before the device may be purchased or the service may be offered.²

CON restrictions are in addition to the standard licensing and training requirements for medical professionals, but are neither designed nor intended to ensure public health or ensure that medical professionals have the necessary qualifications to do their jobs. Instead, CON laws are specifically designed to limit the supply of health care, and are traditionally justified with the claim that they reduce and control health care costs.³ The theory is that by restricting market entry and expansion, states might reduce overinvestment in facilities and equipment. In addition, many states—including Florida—justify CON programs as a way to cross-subsidize health care for the poor. Under these “charity care” requirements providers that receive a certificate of need are typically required to increase the amount of care they provide to the poor. In effect, these programs intend to create quid pro quo arrangements: state governments restrict competition, increasing the cost of health care for some, and in return medical providers use these contrived profits to increase the care they provide to the poor.^{4 “}

- Certificate-of-Need Laws: Implications for Florida, Koopman and Stratmann, 03/03/2015

Link to the paper appears below:

http://mercatus.org/publication/certificate-need-laws-implications-florida?utm_source=Email&utm_medium=TWAM&utm_campaign=Newsletter

Regarding Proponents of ACA and the Bumper Sticker Sized Slogan: “Bending the Cost Curve”. Maybe Not so Much.

“The American middle class has absorbed a steep increase in the cost of health care and other necessities as incomes have stagnated over the past half decade, a squeeze that has forced families to cut back spending on everything from clothing to restaurants.

Health-care spending by middle-income Americans rose 24% between 2007 and 2013, driven by an even larger rise in the cost of buying health insurance, according to a Wall Street Journal analysis of detailed consumer-spending data from the Bureau of Labor Statistics.

That hit has been accompanied by increases in spending on other necessities, including food eaten at home, rent and education, as well as the soaring cost of staying connected digitally via cellphones and home Internet service.

With income growth sluggish, discretionary spending on things like clothing and movies, live shows and amusement parks has given way.” - Basic Costs Squeeze Families, Wall Street Journal, 12/01/2014

Link to the entire story appears below:

http://online.wsj.com/articles/americans-reallocate-their-dollars-1417476499?KEYWORDS=basic+cost+squeeze+families