Someone sit Michael Cannon down before telling him this!

Matthew HoltApparently there some kind of experimental clinical innovation going on in the UK. If this isn’t a typo from 
the Torygraph, how is the mental model of the free-marketeers going to survive? I suspect that Gratzer, Giuliani, Kling & the rest had better join Michael in taking a seat. Yup, communism can mean innovation, (after all who won World War II)?

Meanwhile there is a little more news on the topic of Cato (Michael’s employer). First, they created some economic stimulus of their own Monday, with a one page ad in the WSJ opposing the economic stimulus package.

But they haven’t been listening to Robert Reich and the others suggesting that we get money into the hands of the poor to create more immediate economic impact, or at least they weren’t paying attention when they gave their cash to Rupert Murdoch. Perhaps they should have put it in Street Sheet instead!

On a slightly more serious note, Cannon & Kling kindly sent me by actual snail mail their new article called Does the Doctor Need a Boss in which they argue in favor of coordinated care management (from somebody!) and point out that it’s prepaid group practices (e.g. Kaiser) who come closest to the model. They also call for the dismantling of professional guild protections. I’m totally with them on both issues (and am even happier that they made Greg Scandlen call them “disgusting” although I can’t find Scandlen’s actual quote online).

But it’s a little rich of the libertarian right to start claiming as their own things like integrated care systems, prepaid care, disease management and the like. This is really veering into the through the looking glass, Grace-Marie Turner, territory. If, as these guys all claim, you gave people actual cash to spend on their individual health care spending there would be no chance of these large quasi-social insurance systems like Kaiser and the VA surviving—and Michael knows why (even if Grace Marie remains mathematically challenged). And of course almost all innovations in these areas come in models that have nothing to do with the consumer directed & financed care these guys espouse. If you listen to the leaders of those organizations they’d like the cream-skimmers to go away.

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4 replies »

  1. “More government spending by Hoover and Roosevelt did not pull the United States economy out of the Great Depression in
    the 1930s.”
    Above from CATO ad. In fact it WAS government spending that ended the 30s depression – it was called World War II. As well the destruction of Europe paved the way for the post war expansion in the U.S.
    Deron, you don’t like taxes, can’t say I do either, and I see from past posts that you don’t like the wealthy paying the same % of taxes as you as you think there should be a cap. So, who pays to protect our food system, who pays to protect our environment, who pays to ride herd on the liars on Wall Street, who pays for our court system, probation system, police, fire, who pays to look after abandoned children, who provides food support for families, who pays to at least provide some healthcare for the poor (or would you just like to see them in the gutter?, who pays to reverse global warming and convert from fossil fuels, etc., etc.
    As for healthcare we may be sicker, but we also pay much more to look after the sick. You want obesity solved, that would involve government changing our food culture (such as requiring calorie listings on food) and changing subsidy programs from corn to legumes and fresh fruits and vegetables and instituting a fast food tax to pay for all of this. Not every employer can afford to hire a nutritionist as your company has done -and for which the jury may still be out if it works, unless there is also a hammer to force compliance.

  2. You are simply attempting to disguise ideological views as practical reform. I have yet to see support for the argument that comparison countries spend less because they are largely government run. You need not look further than the latest issue of your beloved Health Affairs to see that the differences in spending are due largely to the fact that we are much much sicker, particularly in terms of chronic illness.

  3. Deron, you make even less sense than Grace-Marie usually does! When you are providing a good/service that costs wildly uneven amounts for different people, you need some form of monetary collection and redistribution to pay for it. If you just let everyone keep their money and pay cash, most people wont spend much and those who need services (i.e. in this case sick people) won’t be able to pay for it. Thus we have insurance.
    You can either inefficient & unfair insurance as we have in the US, or you can have efficient & rational social insurance as other countries do. But no collection of some kind (tax, insurance premium, whatever) means no spending on care for the sick. You might be OK with that (although I doubt your employer is) but I’m not.

  4. Great point Matthew! It’s better if we tax citizens so we never actually see the money we earn, because we all know we can’t be trusted with the freedom to spend it as we choose!