[ExI] Yet another health care debate

Fred C. Moulton moulton at moulton.com
Sat Sep 20 17:30:42 UTC 2008

It appears that periodically a health care debate arises on this list.
And I am always amazed as normally rational people seem to take leave of
their more advanced analytical tools.  Before wasting time and bandwidth
how about performing some basic analysis.

For each health care system under consideration please do the following:

1. Determine what are they component parts and how they are connected;
such as emergency care, pharmacy, etc.  Are there parallel systems?

2. Determine how it is controlled, financed and regulated at the macro
level.  And then how these macro level factors influence micro level
decisions.  And the reverse.

3. To the extent that some or all of a health care system is controlled
by an identifiable entity does that entity have a goal or goals?  Are
these goals internally consistent and do they conflict with the goals of
other groups?  How are these conflicts resolved?

3. Do individuals and groups have alternative options which they can
pursue without penalties? 

4. Are the caps or limits or rationing on various types of care?  Are
all illnesses and diseased covered and to what extent?

5. What are the demographic and other inputs into the system?  This
includes factors such as age, work history, obesity, smoking, substance
abuse just to name a few.

6. How are outcomes identified and measured?  Age of death, amount of
suffering, time on waiting lists for diagnostics, time on waiting lists
for surgery, percentage of persons receiving preventative care, etc.

These are just a few of the items that need to be considered in order to
even begin to have a reasonable comparison of health care systems.  And
please avoid the glib but obviously wrong statements.  For example to
say the USA has a free market health care system just shows a lack of


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