24 thoughts on ““Investing in Health Makes Economic Sense””
Ricardo
Whew! I was worried that this could be a fraud until I saw that Jonathan Gruber had signed. Then I knew this was not intended to fool the people. What a relief.
Patrick R. Sullivan
I laugh.
Patrick R. Sullivan
With the Pope in the country, I guess everyone wants to get in on the moral preening.
Patrick R. Sullivan: That’s one person. The debate is hardly decided.
On the other hand, there are incontrovertible facts.
In this regard, I am still waiting to hear you admit you were in error regarding depth of the downturn in Canada vs. US during the Great Depression. As you recall, you stated unequivocally:
Canada … had a less severe depression than the USA.
Patrick R. Sullivan: No clue, haven’t watched. I think a more technical debate between say Dube and Meer would be useful. But I promise to watch if I hear you admit you were in error regarding depth of the downturn in Canada vs. US during the Great Depression. As you recall, you stated unequivocally:
Canada … had a less severe depression than the USA.
If Menzie is nothing else he does get stuck in a rut. He is still posting on a totally unimportant issue over a year after it was posted. Some call it a one-trick pony. But not Menzie. He also wants everyone in the United States to be on food stamps.
Patrick R. Sullivan: I think it has something to do with the UN…
PeakTrader
There are lots of undesirable effects from crony capitalism, regulations, subsidies, and taxes.
Who’s going to provide the health care “coverage?” Do we really want a VA hospital style health care system?
We’re in a depressed economy with a struggling middle class. Playing by the rules is becoming foolish.
it seems idealistic we can actually provide universal health care coverage, including for the poor and the aging Baby-Boomers, when there’s no more money or little room for trade-offs, unless we make big changes in priorities.
2slugbaits
Peak Trader I think you’re wrong about the VA. The VA provides excellent healthcare…that’s one reason why so many people literally died waiting for VA care. Those people had the option of going to other non-VA hospitals but chose to wait for VA provided care. The VA was mismanaged by GEN Shinseki and VA leadership was criminal in lying to vets about wait times, but the medical care itself is first class.
I think you have some misconceptions about government. The problem with government provided goods and services is not that the government will undersupply that good or service, but that it will oversupply it. Single provider healthcare risks providing more healthcare than is optimal. Private healthcare has exactly the opposite problem; it tends to undersupply.
President Bush deserves a lot of the blame for the VA’s problems because Team Bush refused to increase VA funding to the extent that was needed. Part of the reason is that Cheney and Rumsfeld would not allow any government policies that implied casualties from Iraq and Afghanistan would be as large as they were. They sold the public on the idea of a low casualty war and expanding VA was not consistent with that message. And part of the problem was that wounds that would have killed soldiers in previous wars were non-fatal in Iraq and Afghanistan because of advances in troop protection. That was good news, but it also increased the number of wounded who needed healthcare rather than caskets. Note that even though bureaucracies are inclined to oversupply a good, in this case Team Bush acted like private sector agents and sought to undersupply VA healthcare.
PeakTrader
2slugbaits, why would veterans pay for care somewhere else when they can get it free at the VA?
The private sector will meet consumer demands, while government will supply too much of what isn’t needed and too little of what is needed.
One major problem is VA doctors see far fewer patients compared to private sector doctors.
The veteran population has been in decline, while the VA budget increased:
Veterans Health Administration scandal of 2014 – Wikipedia
Obama Administration investigation
“President Obama’s Deputy Chief of Staff, Rob Nabors, reported to Obama on June 27, 2014 that he found “significant and chronic system failures”, a “corrosive culture”, damaged morale, and a need for additional staff. He reported that the goals for wait times for appointments of no more than 14 days are unrealistic, that data about patient wait times had been falsified by VHA employees, that there are a variety of problems with safety and integrity within the VHA, and that transparency and accountability are lacking. In response to the report, the Republican chair of the House Veterans Affairs Committee, Representative Jeff Miller, said, “It appears the White House has finally come to terms with the serious and systemic VA health care problems we’ve been investigating and documenting for years” and that he would work with the White House to fix the problems. The independent chair of the Senate Veterans Affairs Committee, Bernie Sanders, said, “No organization the size of VA can operate effectively without a high level of transparency and accountability. Clearly that is not the case now at the VA.””
steve
As a vet and physician, let me correct at least one thing here for you. Many vets are not eligible for VA care. The total population of veterans is not the important factor in VA expenditures. The number of people eligible, and the severity of injury/disease are major factors. The recent wars in Iraq and Afghanistan are a big deal for the VA. Also, Agent Orange exposure was recently deemed a valid cause for eligibility. So, in fact, the VA was actually hit with a large influx of patients. As to the quality of care, it is generally rated quite highly. Most vets like it and want to keep the VA running. Yes, the wait times of 14 days were unrealistic, as we don’t meet those in the private sector. Fortunately, this was mostly a problem at relatively few VA facilities, mostly those which have to deal with a large influx of seasonal patients.
Steve
PeakTrader
It has always been the case many vets are not eligible for VA care. it may be easier to get now, but the declining population of vets is an important factor.
U.S. medicine has high standards. However, it seems, below average doctors would be attracted to the VA. They can’t be sued for malpractice and have government protections, although they’re paid less.
Nonetheless, I’m sure, vets are satisfied with the VA. Would you be more satisfied paying $30 for a filet mignon dinner or paying nothing for a sirloin steak dinner? And, isn’t it true those vets receive a check each month based on the percentage of their disability rating, along with other benefits?
baffling
peak, you need to be educated on something.
“U.S. medicine has high standards. However, it seems, below average doctors would be attracted to the VA. They can’t be sued for malpractice and have government protections, although they’re paid less.”
your implication is false. i think you are viewing medicine from the ivory tower of free market ideology in a way that is clouding your views of reality. you need to believe VA doctors are inferior, so that it fits with the narrative of less pay produces less quality, a free market pillar. but the quality of va doctors is quite good. many va doctors are of international origin because visa issues limit their options early in their career. but these are excellent doctors. and many choose to stay on at the va after their visa issues are arranged, because they find the va system is in many ways superior to most hospitals. the va led the way in the use of digital technology to improve communication throughout the hospital, so that nurses, doctors, labs, etc were able to share information quickly and accurately. good people like working there. go ask a medical resident, who splits time between the VA and their home teaching hospital, which institution is better. most VA hospitals are typically very well run. the media uproar recently was limited to a couple of isolated VA hospitals, and did not represent the general performance of the system.
Joseph
“Do we really want a VA hospital style health care system?”
I do. Under the Clinton administration the VA system was the best performing and had the best patient satisfaction of any hospitals in the U.S. Unfortunately, Bush filled the hospitals with cannon fodder and then failed to provide the funding to care for them. Support the troops? Not Bush or the Republicans.
PeakTrader
Obviously, enough propaganda and manipulating data can make the worst system look like the best.
If all else fails, blame Bush 🙂
Robert Hurley
Peak: is it propaganda that the users of the VA system give it higher marks than any other hospital system? I am not sure what you define as propaganda
steve
You probably could blame, at least partially, Bush. The improvements in the VA started well before Obama came into office. While you appear to want to denigrate the VA because Obama might get credit for its improvement, the large jump in quality took place after the reporting on major issues in the 90s. Most of the credit should go to the administrations of Clinton and Bush.
Steve
PeakTrader
I think, Congress plays an important role, including the GOP Congress of the ’90s.
It seems, politicians in the South have tried to help vets the most.
Tom
Just what do you mean by “invest”? The government already spends trillions on healthcare. Rather than “invest” more money, maybe the existing money could be used more effectively.
Replace “healthcare” with “education” and the story is the same. To Democrats, the solution to anything is to “invest”, i.e. spend even more money. We spend more than enough as it is.
Manfred
I just love it when supposedly distinguished economists sign bullshit letters without regard to something like, well, a resource or budget constraint.
Bob
Budget constraint? When liberals speak of spending more money on something, they’re not talking about spending THEIR money. They’re talking about spending your money.
baffling
or they could be helping to educate the policy makers on their choice of resource allocation in light of those constraints. like perhaps we are better off pursuing a path to better health, rather than bombing afghanistan and iraq back into the stone ages? i only wish that if a group of economists writes a bullshit letter that turns out to be off base, they acknowledge their error rather than double down on their wrongness, like the inflationista letter from a few years ago.
Whew! I was worried that this could be a fraud until I saw that Jonathan Gruber had signed. Then I knew this was not intended to fool the people. What a relief.
I laugh.
With the Pope in the country, I guess everyone wants to get in on the moral preening.
For an antidote; https://www.youtube.com/watch?t=4682&v=puPXbYFTV6A
The destroyer of Jamie’s Worlds is Jonathan Meer, of the paper by Meer and West; http://www.voxeu.org/article/minimum-wage-and-employment-dynamics
Patrick R. Sullivan: That’s one person. The debate is hardly decided.
On the other hand, there are incontrovertible facts.
In this regard, I am still waiting to hear you admit you were in error regarding depth of the downturn in Canada vs. US during the Great Depression. As you recall, you stated unequivocally:
And this statement is wrong.
So, speaking as an expert on econometrics, Menzie, you think Jamie had the better of Meer?
Before you answer, think about how many of your students might read your answer.
Patrick R. Sullivan: No clue, haven’t watched. I think a more technical debate between say Dube and Meer would be useful. But I promise to watch if I hear you admit you were in error regarding depth of the downturn in Canada vs. US during the Great Depression. As you recall, you stated unequivocally:
And this statement is wrong.
If Menzie is nothing else he does get stuck in a rut. He is still posting on a totally unimportant issue over a year after it was posted. Some call it a one-trick pony. But not Menzie. He also wants everyone in the United States to be on food stamps.
Ricardo: Let me get you down on (virtual) paper: you are saying health care is a totally unimportant issue?
Patrick R. Sullivan: I think it has something to do with the UN…
There are lots of undesirable effects from crony capitalism, regulations, subsidies, and taxes.
Who’s going to provide the health care “coverage?” Do we really want a VA hospital style health care system?
We’re in a depressed economy with a struggling middle class. Playing by the rules is becoming foolish.
it seems idealistic we can actually provide universal health care coverage, including for the poor and the aging Baby-Boomers, when there’s no more money or little room for trade-offs, unless we make big changes in priorities.
Peak Trader I think you’re wrong about the VA. The VA provides excellent healthcare…that’s one reason why so many people literally died waiting for VA care. Those people had the option of going to other non-VA hospitals but chose to wait for VA provided care. The VA was mismanaged by GEN Shinseki and VA leadership was criminal in lying to vets about wait times, but the medical care itself is first class.
I think you have some misconceptions about government. The problem with government provided goods and services is not that the government will undersupply that good or service, but that it will oversupply it. Single provider healthcare risks providing more healthcare than is optimal. Private healthcare has exactly the opposite problem; it tends to undersupply.
President Bush deserves a lot of the blame for the VA’s problems because Team Bush refused to increase VA funding to the extent that was needed. Part of the reason is that Cheney and Rumsfeld would not allow any government policies that implied casualties from Iraq and Afghanistan would be as large as they were. They sold the public on the idea of a low casualty war and expanding VA was not consistent with that message. And part of the problem was that wounds that would have killed soldiers in previous wars were non-fatal in Iraq and Afghanistan because of advances in troop protection. That was good news, but it also increased the number of wounded who needed healthcare rather than caskets. Note that even though bureaucracies are inclined to oversupply a good, in this case Team Bush acted like private sector agents and sought to undersupply VA healthcare.
2slugbaits, why would veterans pay for care somewhere else when they can get it free at the VA?
The private sector will meet consumer demands, while government will supply too much of what isn’t needed and too little of what is needed.
One major problem is VA doctors see far fewer patients compared to private sector doctors.
The veteran population has been in decline, while the VA budget increased:
http://www.va.gov/vetdata/docs/quickfacts/Gdx-trends.pdf
Veterans Health Administration scandal of 2014 – Wikipedia
Obama Administration investigation
“President Obama’s Deputy Chief of Staff, Rob Nabors, reported to Obama on June 27, 2014 that he found “significant and chronic system failures”, a “corrosive culture”, damaged morale, and a need for additional staff. He reported that the goals for wait times for appointments of no more than 14 days are unrealistic, that data about patient wait times had been falsified by VHA employees, that there are a variety of problems with safety and integrity within the VHA, and that transparency and accountability are lacking. In response to the report, the Republican chair of the House Veterans Affairs Committee, Representative Jeff Miller, said, “It appears the White House has finally come to terms with the serious and systemic VA health care problems we’ve been investigating and documenting for years” and that he would work with the White House to fix the problems. The independent chair of the Senate Veterans Affairs Committee, Bernie Sanders, said, “No organization the size of VA can operate effectively without a high level of transparency and accountability. Clearly that is not the case now at the VA.””
As a vet and physician, let me correct at least one thing here for you. Many vets are not eligible for VA care. The total population of veterans is not the important factor in VA expenditures. The number of people eligible, and the severity of injury/disease are major factors. The recent wars in Iraq and Afghanistan are a big deal for the VA. Also, Agent Orange exposure was recently deemed a valid cause for eligibility. So, in fact, the VA was actually hit with a large influx of patients. As to the quality of care, it is generally rated quite highly. Most vets like it and want to keep the VA running. Yes, the wait times of 14 days were unrealistic, as we don’t meet those in the private sector. Fortunately, this was mostly a problem at relatively few VA facilities, mostly those which have to deal with a large influx of seasonal patients.
Steve
It has always been the case many vets are not eligible for VA care. it may be easier to get now, but the declining population of vets is an important factor.
U.S. medicine has high standards. However, it seems, below average doctors would be attracted to the VA. They can’t be sued for malpractice and have government protections, although they’re paid less.
Nonetheless, I’m sure, vets are satisfied with the VA. Would you be more satisfied paying $30 for a filet mignon dinner or paying nothing for a sirloin steak dinner? And, isn’t it true those vets receive a check each month based on the percentage of their disability rating, along with other benefits?
peak, you need to be educated on something.
“U.S. medicine has high standards. However, it seems, below average doctors would be attracted to the VA. They can’t be sued for malpractice and have government protections, although they’re paid less.”
your implication is false. i think you are viewing medicine from the ivory tower of free market ideology in a way that is clouding your views of reality. you need to believe VA doctors are inferior, so that it fits with the narrative of less pay produces less quality, a free market pillar. but the quality of va doctors is quite good. many va doctors are of international origin because visa issues limit their options early in their career. but these are excellent doctors. and many choose to stay on at the va after their visa issues are arranged, because they find the va system is in many ways superior to most hospitals. the va led the way in the use of digital technology to improve communication throughout the hospital, so that nurses, doctors, labs, etc were able to share information quickly and accurately. good people like working there. go ask a medical resident, who splits time between the VA and their home teaching hospital, which institution is better. most VA hospitals are typically very well run. the media uproar recently was limited to a couple of isolated VA hospitals, and did not represent the general performance of the system.
“Do we really want a VA hospital style health care system?”
I do. Under the Clinton administration the VA system was the best performing and had the best patient satisfaction of any hospitals in the U.S. Unfortunately, Bush filled the hospitals with cannon fodder and then failed to provide the funding to care for them. Support the troops? Not Bush or the Republicans.
Obviously, enough propaganda and manipulating data can make the worst system look like the best.
If all else fails, blame Bush 🙂
Peak: is it propaganda that the users of the VA system give it higher marks than any other hospital system? I am not sure what you define as propaganda
You probably could blame, at least partially, Bush. The improvements in the VA started well before Obama came into office. While you appear to want to denigrate the VA because Obama might get credit for its improvement, the large jump in quality took place after the reporting on major issues in the 90s. Most of the credit should go to the administrations of Clinton and Bush.
Steve
I think, Congress plays an important role, including the GOP Congress of the ’90s.
It seems, politicians in the South have tried to help vets the most.
Just what do you mean by “invest”? The government already spends trillions on healthcare. Rather than “invest” more money, maybe the existing money could be used more effectively.
Replace “healthcare” with “education” and the story is the same. To Democrats, the solution to anything is to “invest”, i.e. spend even more money. We spend more than enough as it is.
I just love it when supposedly distinguished economists sign bullshit letters without regard to something like, well, a resource or budget constraint.
Budget constraint? When liberals speak of spending more money on something, they’re not talking about spending THEIR money. They’re talking about spending your money.
or they could be helping to educate the policy makers on their choice of resource allocation in light of those constraints. like perhaps we are better off pursuing a path to better health, rather than bombing afghanistan and iraq back into the stone ages? i only wish that if a group of economists writes a bullshit letter that turns out to be off base, they acknowledge their error rather than double down on their wrongness, like the inflationista letter from a few years ago.