Arnold Kling  

Sherry Glied vs. Jacob Hacker

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The Paperback Arrives... Emerson on Tipping

In Sunday's Washington Post, Jacob Hacker wrote,


getting the government more involved in health care would actually reduce costs, improve quality and bolster the U.S. economy -- which helps explain why public insurance is the secret weapon in both of the leading Democratic candidates' plans. If socialized medicine means doing what our public-insurance programs and other nations' health systems do to control costs, expand coverage and improve the quality of care, it's high time for a little socialization.

Meanwhile, John Goodman summarizes the results of Sherry Glied's NBER working paper.

Based on an analysis of data from 20 developed countries, she concludes:

There is no general relationship between the way in which countries pay for health care and their ability to control costs. Public v. private financing, general revenue v. payroll taxes, third-party v. out-of-pocket spending - nothing seems to matter very much.

He has more at the link.


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COMMENTS (4 to date)
liberty writes:

I don't think I have access to that NBER article, but-

Somehow I doubt that there is "no relationship" to controlling costs. I think the measures might be too broad. Which costs? How much health care for what cost? What the the quality, wait time, etc? How do you measure unit for unit?

The abstract says "I find that almost all financing choices are compatible with efficiency in the delivery of health care" -- how is efficiency defined?

"Using data on expenditures and life expectancy by income quintile..." -- developed countries have almost the same life expectancy by quintile and life expectancy aggregates many more variables than just health care- crime, war, climate, cultural habits, immigration, etc etc. Somehow I doubt that every potential factor was properly controlled for.

Even if it was, what can you really learn at that point about actual efficiency and cost for each health care system in each country at that point?
Of course, after controlling for a dozen of these variables, you'd not see any difference with regard to life expectancy by quintile across developed countries. There wasn't any to begin with, and it has nothing to do with the health care system per se - it has to do with modern medicine (created in countries with free market systems) - which all of the countries now import no matter how much they have been socializing their own system.

How about using more precise measurements of health care efficiency before making grandiose statements based on a few regressions?

I should probably read the article.

FC writes:

That old-time Progressivism is back. "Let's try something new. And when that fails, let's try something else! Whee!"

Dr. T writes:

What makes a professor of political science believe that he is qualified to propose and predict the effects of health care economic changes (other than the arrogance of ignorance)? Why did the Washington Post publish a lengthy article from a non-expert? Was there a rebuttal article?

Floccina writes:

It does seem possible that the government medical care could reduce healthcare spending but the fact that the same people who are calling for socialized medical care are always calling for more spending for schooling makes me wonder. In medical care, as in schooling, increased spending above some low level seems to have very, very, very, tiny, little, wee, small affects on outcomes. Yet after failure after failure they call for more spending because of course, they say, we just have not spent enough or we did not spend it in the correct way.

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