Quick Pointer

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For more on the health insurance issue, Arnold Kling has an interesting column up at Tech Central Station.

Rather than initiating the poor into the wonderful world of insurance company rules and claims-filing procedures, Fogel suggests that we would do more good by directly providing them with prenatal and postnatal care, health care education and mentoring, child health screening in public schools, and neighborhood public health clinics.

As I mentioned in the comments below, my reading of current health care issues would make me think that Fogel's right by saying that the poor under-utilize certain kinds of health care: preventative care, most notably. The later -- drastically higher -- cost of catastrophic health care is shifted towards other consumers then.

Just more reasons that I'm not sure the real issue facing the country is health care insurance per se, but rather the cost of health care provision.

4 Comments

The only 'preventative' care that really matters is vaccination, and the poor get that.

Most hospitilizations are due to accidents or infections, neither of which is prevented by 'preventative' care.

Hospitals make their money treating (and over-billing) dying people who die anyway. We could end the health care 'crisis' by letting people die 90 days sooner than we do now. Ten percent of the savings could be put into anti-aging research, buying everyone a few decades of extra life.

Perhaps it's more an issue of semantics, but under the umbrella of "preventative", I tend to include things like health education. The obesity issues facing todays kids will turn into diabetes, heart problems, and more, all of which, I think, mean more hospital and physician usage later in life that has to be accounted for. Include the fact that obesity is now a growing problem for the poor (due to the high fat/calorie/carb/etc content of cheap processed food), and it seems like a little education about what to eat might stave off a couple ICUs worth of uninsured heart attack patients down the line.

Though, I may be trying to draw to bright and straight a line frome point to the next.

To solve this problem we must forecast the lowest-cost future.

Is it cheaper to 1) educate all mal-eaters, and save some of them from heart disease in 30 or 50+ years, or to 2) not educate anybody, and have more die from heart disease. This all comes down to the net savings of not having expenditures on other problems minus the expenditure on problems they will have because they're still alive, minus the education expenditure. The education expenditure occurs now, the heart disease or other problems won't occur for 50 years. What will be the cost of treating heart disease then?

Random thoughts...

Hmm. Fascinating. If the cost of treatment is reduced at a faster pace than that of educating people, we might as well just let folks eat whatever they like, and let them have the magic pills 30 years from now.

Personally, I don't care what people eat. I'm a huge fan of personal responsibility. The trouble is, I can't be left alone by a generation of over-eaters since my insurance premiums are reflections of risk spread across a huge group. If the group profile gets worse, I get screwed. So there are externalities I have to face. Now, if we could get rid of the mechanism that enables the externalities...

The trouble with education, I'm betting, is that it means little without positive reinforcement at home. Most of the work I've seen on school performance demonstrates that a major factor contributing to school success is participation by the parents. Active, interested parents are far more likely to have children that are successful in school. I can't imagine health as a topic of education would be any different. if the parents are trying to help kids read about heart disease at a dinner table spread with Big Macs and KFC, my guess is that little information will sink in.

I wonder if smoking might be an informative comparison. The dangers of smoking have been known for a long time, yet plenty of people still do it, many of whom have children. What percentage of the smoking population had parents that smoke? Does education about health effects affect them less than other kids? Etc. and so on and so forth.

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This page contains a single entry by published on July 6, 2004 12:00 PM.

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