RSS Feed MenuRand Paul’s libertarianism stops where his pocketbook starts, or so reports the Wall Street Journal today:
Tea party favorite Rand Paul has rocketed to the lead ahead of Tuesday’s Republican Senate primary here on a resolute pledge to balance the federal budget and slash the size of government.
But on Thursday evening, the ophthalmologist from Bowling Green said there was one thing he would not cut: Medicare physician payments.
In fact, Paul — who says 50% of his patients are on Medicare — wants to end cuts to physician payments under a program now in place called the sustained growth rate, or SGR. “Physicians should be allowed to make a comfortable living.
I guess this is what the original Rand meant by the morality of selfishness.
JoeFlower // May 26, 2010 at 12:07 pm
JimBob writes:
“Joe Flower is a big proponent of a single payer system. In other words, rationing of health care. I rest my case. … Single payer is the epitome of rationing.”
As ktward says, “What case?” Medicare is “single payer.” Is Medicare “rationed?”
When it was a live political question whether the U.S. should move to a single payer healthcare system, my answer was, “Yes.” But that particular argument has been over for a year, and “yes to single payer” never was any kind of final answer – because any system can be made to work better than ours. There is no healthcare economy around the world that pays anywhere near as much as we do. Everyone else pays roughly half or less of what we do, and most get better outcomes than we do. You pay more for less, you’re the chump. When it comes to buying healthcare, that’s us.
Any economic system has to provide some way to choose value. Simple “competition” between providers in healthcare does not do it, because the competition takes the form of providing more and more services without any way for the buyers to tell what is “worth it,” what is necessary, what makes a difference. The evidence is simple: Medicare data show that some places cost three times as much per year per capita, with outcomes that are the same (or even negative, for some diagnoses) in the more expensive places. Compare the high-spending places (such as Dallas, Miami, Los Angeles, and New York) to the low-spending places (like Oregon, Washington, Utah, Minnesota, Wisconsin, Temple TX, Sacramento CA) and what you don’t find is any broad, consistent pattern of differences in socioeconomic level, or ethnic diversity, or age demographic. What you notice is that all the really expensive areas are extremely competitive provider markets, and the less spendy places are more cooperatively organized in a number of different fashions.
And it’s not about quality. The two least expensive medical systems in which to spend the last two years, year, six months of your life are the Mayo Clinic in Rochester, Minnesota, and the Cleveland Clinic.
Healthcare economics is hard. You have to pay attention. You have to watch the hand with the coin in it. Simple bumper-sticker slogans will never get us where we want to go. Where we want to go is to stop being the chump.
FreakOutNation » Tea Party Socialism And The Not So Fiscally Conservatives // Sep 30, 2010 at 9:38 pm
[...] libertarianism stops where his pocketbook starts.” Frum highlighted a Wall Street Journal story from last week in which Paul said he doesn’t [...]