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The best two sentences I read today
According to a study that even the New Republic's Jon Cohn admitted he thought was probably exaggerated, being uninsured killed 18,000 people a year this decade. Methicillin-resistant Staphylococcus aureus, on the other hand, apparently kills 19,000 a year.
That's from Megan McArdle, who continues:
Non libertarians can, of course, go along wishing that we would have national health care and a War on Infection. But it's worth asking yourself: in a world of scarce resources, where you could only have one, which would you choose? And by what principle?
The fact that I have read very few sentences today does not diminish the stellar quality of these thoughts.
Posted by Tyler Cowen on October 16, 2007 at 08:11 PM in Medicine | Permalink
Comments
I agree. Lets go to single payer health care, and use the savings to fight a war on infection.
Posted by: yoyo at Oct 16, 2007 8:16:55 PM
In a world where a libertarian could save 18,000 lives every year or admit that -- in one area of policy -- they were wrong, which would they choose? And with what rhetorical tactic?
Posted by: c&d at Oct 16, 2007 8:22:52 PM
What a dishonest post. Tyler, you have to be kidding me. I am not even a
single-payer advocate though i think there should be some form of universal
coverage, but how can you with a straight face present this false choice
between universal health care and fighting infectious diseases? Please,
leave the political hackery to Greg Mankiw and his ilk...
Posted by: Dan B at Oct 16, 2007 8:32:05 PM
Typical McArdle BS.
Acording to the article, deaths from the infection can be substantially reduced by improved hospital procedures - screening, enforced hand-washing, etc. This is not remotely comparable to national health care.
It's obvious you like to boost McArdle because you like her ideology, but you really should pay more attention to what she says, which is generally pretty stupid.
Posted by: Bernard Yomtov at Oct 16, 2007 8:47:33 PM
yoyo is right. McArdle is a hack.
Posted by: joeo at Oct 16, 2007 8:54:17 PM
The choice isn't so much a false one as those sentences make them out to be. MRSA is an infection contracted during hospital stays.
Of course, the false choice remains in the most part. Hospital procedure is not health care policy.
If we need better of both why not have better of both?
Posted by: talboito at Oct 16, 2007 8:55:32 PM
Lots of insult and denial have we here. No one is saying that reform X (whether it be single payer or something else) vs. fighting infection is *the* choice, in fact quite the contrary possibility is presented. Just admit the inconvenient fact: "It is quite possible that my favored health care reforms aren't nearly the best way to help other people. But I promote them anyway because [fill in the blank]." Depending on what you put in the blank, you still might think it is better to promote your preferred reforms. But they won't sound nearly as efficacious or as noble as before. The critics in this comment thread are reacting exactly as people do when they feel their relative status has been knocked down a notch. Which it has.
Posted by: Tyler Cowen at Oct 16, 2007 9:11:04 PM
pretty funny 'cause I read this and thought to meself "hey Angus, that McArdle might be much better than I've been thinking, I need to give her another chance".
but then I thought again and agreed with talboito: Choose? Hell no! I want more of both!
Posted by: angus at Oct 16, 2007 9:26:26 PM
Public hospitals could always enforce a necktie ban. This would make more sense, though.
Posted by: Amber at Oct 16, 2007 9:39:21 PM
Tyler,
I hope that our thoughts and fears and morals are not really so far apart.
Imagine a hypothetical example. Let us say that I live in a small town and 50 people a year are killed in automobile accidents while 10 are murdered by muggers.
In my universe, muggers are something more scary and something I will do more to stop, even though the actual numbers are smaller and maybe even harder to reduce than accidents. Possibly the accidents could be easily reduced by lowering speed limits and more rigourous enforcement of dui infractions....but I don't care.
I think the same is true of medicine. I don't want to live in a society where I read in the paper of a child in Maryland who dies because he could not afford good dental care...while I sometimes forget to wash my hands when I should. I am less concerned about accidental death through sloppy practices than I am about intentional refusal of care.
Maybe, in the abstract that make me irrational, but hey if this is irrationality, I don't care. I think if you can step over a sleeping homeless person without a twinge just because you are on the way to mail in your contribution to charity, you are an unusual sort of person.
Posted by: robbL at Oct 16, 2007 9:43:54 PM
Robbi's comment is honest and insightful.
Posted by: Tyler Cowen at Oct 16, 2007 9:55:00 PM
Shoot, I feel for you. Sentences get a lot better than that.
Today I read:
And so these parties divided upon that midnight plain, each passing back the way the other had come, pursuing as all travelers
must inversions without end upon other men's journeys.
and:
You and the Mrs. wanna come to T-town to see Tool on 11/19?
Both of which did a lot more for me.
Posted by: Different Jeff at Oct 16, 2007 10:09:03 PM
To me natioalized healthcare for Americans as charity makes little sense because:
We already have Medicaid and because a few thousand dollars spent in a very poor country will help the people there more than a million dollars spent here on healthcare.
Posted by: Floccina at Oct 16, 2007 10:19:02 PM
Tyler, perhaps I'm dense, but explain to me how, "in a world where you could have only one" does NOT present a false choice. Note that I'm not suggesting a single-payer system is without serious flaws. I think your previous post did a fine job presenting several counterpoints.
But when you say: "No one is saying that reform X (whether it be single payer or something else) vs. fighting infection is *the* choice, in fact quite the contrary possibility is presented," what the hell are you talking about?
Posted by: mrshl at Oct 16, 2007 10:40:19 PM
Those must have been the only two sentences you read today. Neither makes much sense, or follows logical rules. False choices, comparing apples & oranges.
Posted by: tom at Oct 16, 2007 11:09:29 PM
Tyler,
I sympathize with your unhappiness with the invective directed at you here, but I must agree with
yoyo and some others that this does not seem to be a directly comparable choice. After all, while
many single payer schemes might end up costing more than what we have now, some might indeed save
money, with the elimination of all the excessive "administrative" activities by private health
insurers (trying to avoid paying for care). In that case, indeed it is a false choice. One can
easily do both.
Now, another problem is that it is not at all clear how expensive fighting this infection would be.
The article suggests that maybe up to about a 60% decrease could come about from some relatively
simple improvements in hospital procedures, screening patients more carefully and making sure
personnel wash their hands and wear gloves, these latter being things they ought to be doing in
any case. So, these sorts of things do not exactly seem like something that is in real conflict
with whatever costs there may be from a single payer or other national health insurance plan,
although maybe this improved screening might be.
Finally, just to point out the problem, I can easily think of other things that kill even more
people that we might be able to do at least something about, and then pose it as an alternative
to national health care, e.g. all the deaths from auto accidents and smoking and so forth. McArdle
could just as easily, and just as absurdly, have pointed her fingers at one of these, for which
the deaths are substantially greater than from MRSA. So, the invective has been overdone, but the
point is pretty well taken.
Posted by: Barkley Rosser at Oct 16, 2007 11:37:38 PM
Robbl's post might be insightful.
But after reading such comments, it's easy to understand why Greg Mankiw closed his comments section down recently.
Posted by: thehova at Oct 16, 2007 11:40:49 PM
I didn't take it as a false choice. It's a hypothetical situation to force you to think about your relative values. Why is the political push for a war on infection not as large as the push for universal health care? That's what question the second sentence seemed to point out.
Posted by: Trey at Oct 16, 2007 11:46:48 PM
I didn't take it as a false choice. It's a hypothetical situation to force you to think about your relative values. Why is the political push for a war on infection not as large as the push for universal health care? That's what question the second sentence seemed to point out.
Posted by: Trey at Oct 16, 2007 11:47:01 PM
I didn't take it as a false choice. It's a hypothetical situation to force you to think about your relative values. Why is the political push for a war on infection not as large as the push for universal health care? That's what question the second sentence seemed to point out.
Posted by: Trey at Oct 16, 2007 11:47:11 PM
After reading such odd negative comments, my guess is that one person is signing them with different names.
angus sums up the stupidity:
"pretty funny 'cause I read this and thought to meself "hey Angus, that McArdle might be much better than I've been thinking, I need to give her another chance".
but then I thought again and agreed with talboito: Choose? Hell no! I want more of both!"
I can't believe someone posted this on an economics blog.
Posted by: thehova at Oct 16, 2007 11:50:59 PM
As uninsured constitute about 15% of the population, saving "mere" 10000 of them would be equivalent to much higher per capita mortality reduction than 20000 saved amongst total population. Morally, one expects the society to allocate resources where the relief would be felt most, not to spread them uniformly, as dogmatic communists and libertarians might wish.
This reasoning is (of course) intentionally flawed - just like any of those pseudo-market comparisons with unstated goals and constraints. I am surprised to see such gibberish here.
Posted by: eovdedn at Oct 16, 2007 11:52:56 PM
Not many people are really answering the question posed by Mcardle. Most thinking people should have a hard time choosing. Despite being a libertarian, I am a former liberal, and having a soft spot for some sort of national medical program comes with the territory. My thinking goes that the long run benefits of a completely free market system MAY outweigh the short term welfare costs. But its hard to say really. In the medium term they may balance each other out.
And to quote a movie (Fight Club), "In a long enough time frame, the survival rate for everyone falls to zero." So really we are balancing out long term and short term effects. The answer to the question shouldn't be obvious enough to you to post a comment claiming some sort of truth 5 minutes after Tyler posted. I doubt we should ever be able to answer.
Posted by: stanfo at Oct 17, 2007 12:10:14 AM
What's going on here? You posted some a really dumb quote and you got called on it. Why so defensive? Everybody makes mistakes, just get over it.
Here's what that quote said: "Single-payer health care could save X lives. Reducing the speed limit could save X + 1 lives. More people want single payer health care than to reduce the speed limit. Therefore there's something suspect about wanting single-payer health care."
Face it, it's just dumb.
Posted by: Robby Robot at Oct 17, 2007 12:33:38 AM
Quoting an earlier poster, "I agree. Lets go to single payer health care, and use the savings to fight a war on infection."
Let's have single payer food, single payer auto insurance, and single payer housing while we're at it because the government has such a fantastic track record at delivering quality products at a reasonable price.
I'm just curious how the moment you add the words "health care," people start falling for ridiculous arguments that they would reject out of hand in any other context.
Posted by: mgunn at Oct 17, 2007 2:13:57 AM
