David R. Henderson  

My Letter to Wall Street Journal

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On Monday, I sent a letter to the Wall Street Journal about its editorial, "The Separation of Health and State." Here it is:

The title of your editorial, "The Separation of Health and State" (April 6), was better than the content. Given the Journal editorial page's admirable devotion to free markets, the title leads the reader to expect that the Journal would advocate separating the state from health care. But no such luck. Instead, the editorial criticizes the British government for trying to limit taxpayer spending on health care. The editorial also warns that the U.S. Medicare system may also try to limit spending. Oh, the horror.

Nowhere in the editorial do you point out that if the British government refuses to pay for an expensive medical procedure, people in Britain are still free to pay for it themselves or to buy insurance for that procedure. Isn't the ideal that people should pay for their own health care or their own health insurance? And, if not, why exactly did the Journal oppose Obamacare?

You would be right to fear a government that not only won't pay for expensive procedures but also won't allow people to spend their own money on such procedures, as Canada's government often does. But if that's your objection, say so. We have huge deficit problems in our future and one of the main culprits is Medicare. If we don't support limiting Medicare benefits, that nasty future will come earlier than otherwise.

David R. Henderson
Research Fellow, Hoover Institution
(Henderson was the senior economist for health policy with President Reagan's Council of Economic Advisers)


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COMMENTS (4 to date)
Liam writes:

Standing and clapping

Steve writes:

As I understand it, in Great Britain if you buy your own care you forfeit your ability to receive any government care at all (you cannot buy care only at the margin).

David R. Henderson writes:

@Liam,
Thanks.
@Steve,
My understanding is different. I think I remember a recent case that supports what you're saying, where NHS played hardball and tried to deny care to a woman who had paid for her own. But I think the usual case is one where you can buy care at the margin, although the margin is sometimes quite thick.

Duncan writes:

@Steve,
David is correct. For instance, it's fairly common for people to pay for an operation recommended by NHS doctors, in order to queue-jump (they may even be treated in the same hospital and by the same surgeon as the NHS would eventually provide) without affecting their claims on the NHS for any subsequent services.
He's also correct in saying that there may be particular exceptions. For instance, someone coming off a private dental plan may then have difficulty registering with a (subsidised) NHS dentist in certain areas of the country, but a newcomer to that area would face the same problem.

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