In this post I noted that the Canadian health care system had enacted a law that basically eliminated the in vitro fertilization (IVF) techniques in Canada by prohibiting payment to women who donate their eggs. I noted that while this could be an unintended consequence, it might also be a clever attempt to limit access to the health care system. The limiting of access to the health care system is one way to constrain the costs of providing health care at a national level. Since most people think only of money when they think of costs, increasing non-monetary costs such as wait times, access to certain techniques, etc. would be seen as effective ways of controlling the monetary costs.
Now in the comments to that post a commenter, kappiy wrote the following,
A better solution would be to make IVF treatment entirely market based. Meaning, there would be no public moneys spent on regulation (for health and safety), and women would be free to sellf their eggs at will.
While this might sound like a good solution, I doubt the people who run the health care system in Canada would like this idea. The problem would be that IVF techniques are expensive. As such it would be a lucrative profession for health care workers to go into. If it was cut loose from the Canadian health care system the effect would be to suck resources (namely doctor’s, nurses and other staff) from the Canadian health care system and into the new private market for IVF techniques. This would mean that the Canadian health care system would have to compete for these resources which would likely mean higher wages which would drive up the costs for the Canadian health care system and defeat the very goal of controlling costs. Now the Canadian government could try to controlling the problem by limiting the wages of those working the IVF field, but that would basically have the same effect as we are seeing now–i.e., no IVF market.
So, this mixed approach probably wont work. In fact, I submit that part of the problem with costs in the U.S. is the mixed approach we have. We have massive government intervention in the health care industry. Medicare is basically a mutli-billion dollar subsidy for consuming health care resources. It shouldn’t be hard to see that such a subsidy will drive up prices (costs) in general. If we go the route of completely nationalizing health care in this country we could very easily control costs. The problem is that it will likely mean a degredation in the quality of care that is provided. I know many people like to point to the life expectancy statistics to “debunk” this claim. However, one has to remember several points about life expectancy statistics. The first is that more than the quality of health care goes into determining life expectancy. I’m sure we have all seen the news headlines that Americans are…robust shall we say in regards to their weight. Further, there is quite a bit of violent crime in the U.S. I don’t know if that plays a role in life expectancy variations from one country to another, but I’d at least like to see some attempt to control for it. Another factor is that, you can change the results of life expectancy by re-directing health care resources. For example, if more resources are directed at infants and young children this could bump up the life expectancy. So I am not convinced that the different life expectancies is strong or even weak evidence in favor of nationalized health care.
My over all feeling on this issue (heck on many issues concerning the allocation of resrouces) is that there isn’t much thought that goes into it. People all to frequently assume that there is just two variables at work such as health care and life expectancy. Taxes and economic growth. Social security and taxes. There seems to be a severe lack of appreciation that many of these issues have multiple variables that influence what we are observing and focusing on just one or two can give a misleading picture.
