McArdle attended a seminar:
‘Most participants agreed that if you want to control costs, you need to stop third-party payers from paying for new technologies — particularly Medicare, which is not very discriminating, and which makes it hard for private insurers to deny a treatment that the U.S. government has thereby endorsed. Several people argued rather hopefully that the government could do this — and maybe even would do this, with moves, in Medicare and Obamacare, toward bundled payments and “Accountable Care Organizations.” But no one offered any reason to believe that the government, or the ACOs, would only shut down bad innovation.’
Who makes the decisions, and how will they do it?
From the comments:
‘One of the reasons national healthcare will not work in the US is that US doesn’t have powerful technocrats who can do the right thing regardless of politics. In the US everything that involves government ends up drowning in the political squabbles and thus is made extremly ineffective, slow and expensive.’
Uh, that’s by design. Welcome to America!
Addition: How much are public schools, unionized or not, willing to reform themselves? What about the NY Times and old print media? What about the guild structure of higher education?
Is the rate of change of technology slowing down, staying steady, and how much will regulation get in the way?
The government has grown steadily for decades now, and a lot of inertia is built into the system. In California, especially, but nationwide, we’ve seen the growth of a very muscular individual freedom aided by technology , which is changing how all people, but young people, especially, live their lives and adjust their expectations. But we’ve also seen the growth of green thinking, the decline of religion in the public square for better or worse, the rise of ‘spirituality,’ the rise of the cultural revolution of the 60’s through our political and social institutions.
Perhaps we’ve also seen the growth of an excessive egalitarianism, and a promise for ever more groups of people to be included into an American identity and ‘greatness’ as well.
Peter Thiel and Andy Kessler, interviewed by Peter Robinson touch on all of these issues:
From The New England Journal Of Medicine Via CATO: ‘The Constitutionality of the Individual Mandate’From If-Then Knots: Health Care Is Not A Right…But Then Neither Is Property?… From The New Yorker: Atul Gawande On Health Care-”The Cost Conundrum”…Sally Pipes At Forbes: ‘A Plan That Leads Health Care To Nowhere’…