Wednesday, October 20, 2010

Curb Medicare Spending the Ryan Way | Michael F. Cannon | Cato Institute: Commentary

Curb Medicare Spending the Ryan Way | Michael F. Cannon | Cato Institute: Commentary: "experience and public choice theory suggest that the Ryan plan has a better shot at reducing future Medicare outlays than past efforts, because the Roadmap would change the lobbying game that fuels Medicare's growth.

Medicare dictates the prices it pays clinicians, facilities, medical suppliers and private health plans through more than a dozen different price-control schemes. Efforts to reduce those prices typically fail because of what Tom Daschle calls the 'patient-provider pincer movement': Medicare enrollees and health care providers join forces to undo those cuts.

Each producer that depends on Medicare for its income faces an enormous incentive to lobby for higher prices. The prices for, say, hospital services could make or break a lot of hospitals. And if the hospitals don't lobby to increase those prices, who will? Enrollees like the easy access to medical care that comes with higher Medicare spending."

"The Roadmap, in contrast, would substantially diminish each producer group's incentive to lobby for greater subsidies."

"If hospitals lobby for a higher voucher growth rate, how will they know that the added subsidies will come back to them, rather than ambulatory surgical centers? Many groups would just free-ride on the lobbying efforts of other groups."

"A voucher system would also put downward pressure on prices across the entire spectrum of care."

"Seniors spend their Social Security checks on lots of things, but we don't see golf courses or metal-detector manufacturers lobbying to increase Social Security spending the way health care providers lobby to increase Medicare spending. This largely explains why, on a per-capita basis, Social Security outlays grow at roughly the rate of the economy, while Medicare outlays grow about 2 percentage points faster."

"Vouchers are the most plausible way to restrain Medicare spending. They are also the most humane way, because they let enrollees retain the benefits that mean the most to them."

Time as a Price - Predrag Rajsic - Mises Daily

Time as a Price - Predrag Rajsic - Mises Daily: "A recent study has shown that in most of [Canadian emergency rooms] the average wait time exceeds 6 hours and sometimes reaches up to 23 hours."

"constantly full waiting rooms are not an unavoidable fact of life but a product of a 'priceless' supply system, where waiting for service acts as a rationing substitute for the market price."

"Most people have some mild health-related problem most of the time, but it would not be worth it to them to wait for six hours to receive treatment. They might, however, be willing to wait 20 or 30 minutes or even an hour. The wait time is the only price they pay for the service, but if the price is too high, these people will choose not to use the service offered by the healthcare provider.

However, there are always a small number of people that would be willing to wait six or more hours because the value they put on their particular health problem is quite high. Generally, as the wait time decreases, the number of people willing to wait increases. For example, in our city of 300,000 people, I would expect far more than 5 (or even 30) persons per hour coming into the emergency waiting room if they had to wait only five minutes to receive a service and not provide any money in return."

"While paying for a service with money represents an exchange of claims over resource ownership, paying for the same service with time represents outright resource destruction. The time spent in waiting is lost forever and cannot be used in any productive activity, whereas the money paid for service could be used for purchasing goods and services that had already been produced. The time not spent in waiting could be used for the production of new resources."

Death-wish Democrats | Richard W. Rahn | Cato Institute: Commentary

Death-wish Democrats | Richard W. Rahn | Cato Institute: Commentary: "The average deficit when the Democrats were in control was 4.4 percent of gross domestic product (GDP), 3.9 percent when control was split and only 1 percent when the Republicans were in charge."