"Universal coverage kills," warns the latest missive from Michael Cannon (as opposed to non-universal coverage, which prefers to let you die). The evidence? Medicare just decided to end reimbursements for "never events" -- events that should never happen. A patient has a sponge left in her during surgery, or is given a blood transfusion of the wrong blood type. Cannon scoffs at this. "When a patient requires follow-up care to repair the damage done by a medical error, how does Medicare respond? It pays providers for the 'care' that injured the patient, and then pays them again to repair the damage. Imagine paying your contractor more because he knocked down the wrong wall...More than 60 years ago, markets devised health plans that discourage medical errors by forcing doctors and hospitals to bear the financial costs of all such errors. You know them as plans like Group Health Cooperative and Kaiser Permanente...Why does it take Medicare more than 40 years to take such baby steps? Especially when the market developed a solution to this problem over 60 years ago?" Checkmate, public sector. Checkmate. Of course...the market hasn't quite succeeded here. The vast majority of doctors are private. The vast majority of doctors remain on fee-for-service plans. Kaiser Permanente and Group Health Cooperative have not pioneered a new norm of salaried physicians. Not even close. Meanwhile, the Veteran's Administration, which is the country's largest socialized health care system, has its doctors on salary. Indeed, as the VA demonstrates, when government takes over health care, it salaries its physicians. So do most other socialized systems around the world. When government simply pays for health care on the private market, as with Medicare, it does not salary the physicians because it does not employ them. Instead, it pays them under private market norms. Weird how that works -- it's almost as if the market, where physicians retain their fee-for-service status, is failing us, but socialized systems worldwide have figured out the salary thing. As for the 40 years it took Medicare to solve this problem, I'd be interested to hear Michael explain why the private market didn't adopt this apparently common-sense innovation earlier. The New York Times reports that "three years ago, HealthPartners, a Minnesota-based health maintenance organization, was first in the country to refuse payment to hospitals for never events." So far as we know, the first modern health insurance plan was started in 1929, in Dallas, Texas. So it took the private market 79 years to implement this regulation, while the public sector took a mere 40. I'm not really sure why Libertarians see this one as such a coup.
