THE MORAL-HAZARD MYTH
The bad idea behind our failed health-care system.
This is a great article (very interesting and highly readable) that talks about how our inflated perception of the role moral hazard plays in health insurance has led to the failure of our health system in comparison to those countries who don't share our obsession with moral hazard. Best paragraph from the article IMO:
The moral-hazard argument makes sense, however, only if we consume health care in the same way that we consume other consumer goods, and to economists like Nyman this assumption is plainly absurd. We go to the doctor grudgingly, only because we’re sick. “Moral hazard is overblown,” the Princeton economist Uwe Reinhardt says. “You always hear that the demand for health care is unlimited. This is just not true. People who are very well insured, who are very rich, do you see them check into the hospital because it’s free? Do people really like to go to the doctor? Do they check into the hospital instead of playing golf?”

17 Comments:
I typed in the incorrect address so the link to the article doesn't work. Here is the address by which you can access the article:
http://www.newyorker.com/fact/content/articles/050829fa_fact
Interesting article kilroy. However, I would still have to disagree with the argument that the demand for healthcare is not unlimited.
First, the reason you would choose to play golf rather than go to the doctor is a question of opportunity cost, not a question of limited demand. A system of universal healthcare lowers the opportunity cost of going to the doctor and therefore makes it much more likely that I will go to the doctor for the slightest ailment. Throw into the mix the compensation that these welfare states provide to workers who miss any time due to sickness, you might understand why a person with a head cold might go to the doctor get his medicine and then go play some golf, while the government (or should I say taxpayers) foot the bill.
I lived in Spain a country widely recognized for socialized medicine and saw first hand the realities of universal healthcare. Visit a Spanish hospital where you have to take a number and wait, not hours, but days for a doctor to check you out, and then tell me that there is not an unlimited demand for free healthcare. Reality is much more convincing then theory any day.
Galt's gulch:
I wouldn't argue that the number of people who would choose to go to the doctor rises in a system of social health care. However, is this a bad thing? Many people in the U.S. who cannot afford private health insurance elect not to got to the doctor, but instead "tough it out". This often leads to a worsening of the illness, creating a greater cost on the economy when it reaches a stage that it must be treated. How often do the poor working families without insurance go in for a routine medical or dental checkup? Cancers and other ilnesses are not diagnosed in time to provide effective treatment, and preventative medicine can't be practiced.
How can the demand for health care be unlimited? Do you really think that healthy people are going to go to the doctor just because they have nothing better to do? Do you enjoy your doctor visits? The demand is limited by people's need for health care. This need is not unlimited.
As to your specific experience with having to wait a few days for a doctor's appointment in Spain, perhaps their system has some problems. However, I think the fact that a foreigner without insurance can be treated for free for his condition is a remarkable improvement over our own system. I have foreigner friends without insurance who would love to just have to wait a few days to be treated. Here are the rules for the entitlement of foreigners to health care in Spain.
Foreigners (other than those covered by EU legislation) are entitled to receive health services in the following cases:
- foreigners registered in Spain in the municipality in which they are resident are entitled to receive health care under the same
conditions as Spaniards;
- foreigners under the age of 18, whatever their status, are also entitled to receive health care under the same conditions as Spaniards;
- other foreigners in Spain are entitled to receive emergency pub-lic health care in the case of serious illness or accident and preg-nant women are entitled to care during pregnancy, childbirth and the ensuing period;
- political refugees and stateless persons are also entitled to health care.
(A full explanation of the Spanish health-care system can be found at the following link:
http://europa.eu.int/comm/employment_social/missoc/2002/03/spain_en.pdf
The richest country in the world leaves millions and millions of Americans and foreigners without adequate health care, while other less-fortunate countries are able to provide.
Ironically, socialized health care would cause people to act as if they did not care about others. As Galt's Gulch said: more people would go to the doctor for the slightest of ailments, therefore causing backups and delays for those who truly NEED the care. Allowing markets to set the price of health care will cause people to forgo going to the doctor unless they need to, thus allowing those value the care most to obtain it.
Remember: Socialism breeds mediocrity
j. alexander,
did you meant to say, "...therefore causing backups and delays for those who truly ARE FORTUNATE ENOUGH TO BE ABLE TO AFFORD the care"?
as for obviously well known and supported fact that socialism breads mediocrity, how can you be so sure? don't you think that majority of the people, regardless of the system that produced them are mediocre and perfectly fine with that? and do you really believe that no extraordinary, brilliant individuals come out of political systems other than the one in this country?
anil_okin:
What I meant when I said socialism breeds mediocrity is that in a government-run system, people will not have the incentive to become better at what they do. In order to succeed in a free market, producers MUST always strive for excellence in order to maintain their customers. In a socialist system, people get paid no matter how good they are, so where is their incentive to become better? Just look at what has happened in the private industry of computers. Computer makers operate in a free market, and computers continue to get better and cheaper. It seems that as soon as you pay for a computer, a faster, sleeker, cheaper one comes out... that is the result of the free market: the continuous pursuit of excellence. The same would be true in privatized health care; doctors would need to constantly improve quality and lower cost in order to stay in business. If health care was free, doctors would not feel competitive forces for patients, therefore they would have no incentive to become excellent at what they do...they would be mediocre. Let me ask you this: if you're going to have open heart surgery, would you want to do it in a socialist system or a capitalist one?
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