Arnold Kling  

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proposals in his book, including a plan to scrap Medicare, Medicaid and employer-based health insurance in favor of vouchers that people could use to purchase coverage.

It was not me, although I would be quite happy with those ideas. Thanks to Tyler Cowen for the pointer.


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COMMENTS (7 to date)
Jacob Oost writes:

Dr. K, can you explain to me why so many libertarians are in favor of health care vouchers, rather than simply freeing up the health care system? I understand school vouchers, we all benefit when we are more literate, can do arithmetic, understand how the government works, etc. But not health care vouchers.

I would like to see licensing boards turned into voluntary certification boards (and have the boards privatized), I would like to see the government eventually cut off medicare and medicaid (not pull the rug out from people who depend on it now and have no options, like the elderly or severely disabled), and I would like to see fewer procedural regulations, and liberalization of prescription drug laws, as well as the abolishment of the FDA. I'd also like to see the entire legal system reformed in much the same way, so as to make litigation the primary regulator.

If these measures were undertaken, after the industry adjusted to them, I think health care costs would drop dramatically at the provider level. I don't see the need for vouchers. To say nothing of the morality of forcing people to pay for others' health care.

lukas writes:

As in education, I guess vouchers can be a good tool in order to enable transition to more customer oriented, free market structures. Suddenly, you gain a lot of flexibility.

Gavin Andresen writes:

Vouchers, or any other mechanism that gets consumers shopping for health care, are better than any of the other "in the realm of possibility" alternatives.

It's even possible they'd be better than a completely free-market system; maybe people will be more productive if they don't have to worry about losing basic health care if they lose or quit their job. Maybe we'd have more entrepreneurs, more innovation, and we'd all be better off.

(I doubt it, but I'm biased...)

bhill writes:

"I'd also like to see the entire legal system reformed in much the same way, so as to make litigation the primary regulator."

Wow. Make litigation the primary regulator of healthcare? I'd love to see the ads for that, "More ambulance chasing attorneys will free the nation from spiraling health costs."

Obviously you've never seen the inner workings of a hospital, or even spent any time behind the scenes in an ER. Billions of dollars are wasted on unneccessary tests to exclude the 1% chance of something because the doctor wants to cover his butt. See, he can order the test at no cost to himself and avoid a miniscule chance of missing something, or he can use his judgement, and risk a potential multimillion dollar suit. How's that for economic incentives at work.

George writes:

Zeke Emanuel is the lipstick.

Obama's eventual health care policy is the pig.

None of his good ideas will be used; he's just there to make the doctors feel better about the whole thing.

Floccina writes:

Jacob Oost asks:
can you explain to me why so many libertarians are in favor of health care vouchers, rather than simply freeing up the health care system?

I think that is because they do not see your very good suggestions as being politically feasible. Here is a more politically feasible alternative:

Government provided insurance for all with a low deductible for the poor and huge deductible (like $200,000 for people making more than $100,000 per year) for the middleclass and rich might work and highly tax any gap coverage.

Means tested State funded health insurance

Anual Income family of 4 Deductable per year
Jacob Oost asks:
can you explain to me why so many libertarians are in favor of health care vouchers, rather than simply freeing up the health care system?

I think that is because they do not see your very good suggestions as being politically feasible. Here is a more politically feasible alternative:

Government provided insurance for all with a low deductible for the poor and huge deductible (like $200,000 for people making more than $100,000 per year) for the middleclass and rich might work and highly tax any gap coverage.

Means tested State funded health insurance could work like this:

Anual Income Deductable
family of 4 per year
$20,000 or less $300.00
$20,000 - 30,000 $300 to $10,300
$30,000 - 40,000 $10,300 to $20,300
$40,000 to $50,000 $20,300 to $40,300
$50,000 to $70,000 $40,300 to $100,000
$70,000 an dup $200,000.00

This would encourage the rich and middle class (mostly capable people) to work politically (reduce licensing etc.) and through the market to drive costs down.

caveat bettor writes:

Floccina, I think that Medicare and Medicaid does means test, and it has created massive inflation. (On the other hand, Walmart does not means test, and has increased access--of even healthcare--to the poorer class).

Jakob, I believe vouchers provide some social safety net contract power, but also do not distort the price mechanism like most other government programs. There remains an element of individual freedom and expression of preference in vouchers.

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