Wishful Thinking about Universal Coverage

One Richard Eskow criticizes an op‐​ed that Mike Tanner and I wrote for the L.A. Times. Rather than fisk the whole thing, I’ll zero in on just this one claim:

[W]hile the authors observe that some people on waiting lists are in chronic pain, they fail to note that few if any universal coverage advocates believe that is anything other than a flaw that needs to be corrected.

A flaw that needs to be corrected! Et si ma tante en avait, elle s’appellerait mon oncle.


In a Cato Institute policy analysis titled “Health Care in a Free Society: Rebutting the Myths of National Health Insurance,” John Goodman explains why Eskow’s belief that waiting lists are minor problems to be corrected is mostly just wishful thinking:

The characteristics described above are not accidental byproducts of government‐​run health care systems. They are the natural and inevitable consequences of placing the market for health care under the control of politicians. Health care delivery in countries with national health insurance does not just happen to be as it is. In many respects, it could not be otherwise.…

Why do national health insurance schemes skimp on expensive services to the seriously ill while providing so many inexpensive services to those who are only marginally ill? Because the latter services benefit millions of people (read: millions of voters), while acute and intensive care services concentrate large amounts of money on a handful of patients (read: small numbers of voters). Democratic political pressures in this case dictate the redistribution of resources from the few to the many.

Goodman offers other examples of problems inherent to political control of health care that are not so easily fixed. Read the whole thing.