Healthcare and Misdirection

The angst over the Obamacare debate before the Supreme Court is simply weird.

The entire concern by government officials, as echoed through the criticism of the American system by the Europeans, is that no nation can afford to spend 16% to 18% of its GNP on health care. When Hillary was constructing her plan fifteen years ago its architect, Uwe Reinhardt, said that medical costs should make up no more than 10 to 11 percent GDP. So? So....the point is cost, not coverage; expense, not health care. This entire debate is being held as if the point was somehow to deliver more health care to more people; the actual debate is how to cut the expense of health care. That sounds like decreasing medical care, regardless of the size of the population the system is supposed to serve.

Now it is true that people without plans and living on the charity of others use emergency rooms as local practitioners and putting them in a plan may, or may not, change their behavior. And people have bad habits that drive up the cost of care. But certainly no one would suggest that decreased emergency room visits by the indigent or taking salt off McDonald's fries would decrease medical expenses from 18% of GDP to 11%. That is a 38% reduction.

That 38% is not coming out of efficiencies or fraud. That is coming out of services.