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Healthcare Costs and the Myth of Long Waiting Lines, Cont.


Exam week means blogging will be short, sweet, and intermittent. 

To completely understand the scope of this post, please review this post in which I argue that waiting times for health services is an inaccurate measure of a health system's efficiency because excessive costs keep people from joining the list in the first place.  This is what statisticians and economists would call a Heckman selection bias where the sample is biased by the dependent variable itself. 

The New York Times today:

As increasing numbers of the unemployed and uninsured turn to the nation's emergency rooms as a medical last resort, doctors warn that the centers -- many already overburdened -- could have even more trouble handling the heart attacks, broken bones and other traumas that define their core mission.

...The number of patients coming to emergency departments has been steadily increasing. Helping push up that volume have been the growing ranks of the uninsured, because emergency rooms are legally obliged to see all patients who enter their doors, regardless of their ability to pay.

So, building off my previous post, Americans are foregoing preventative care because they cannot afford it, keeping waiting lists short.  However, because they have not received preventative care, when their condition worsens they are forced to receive acute or emergency care.  The large numbers of uninsured in America thus end up clogging up the nation's emergency rooms and hampering their response to life-threatening situtions.

The argument that a recession is the wrong time for a healthcare bill is utter nonsense.   The growing numbers of uninsured will further drive up health insurance costs due to adverse selection and will make our system even less efficient.  We need everyone to have access to preventative care.

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If we do health care reform correctly, the govt would assist medical students in paying for their education on the one hand, while insisting that payment for health services is based on the "time spent" rather than the "procedure performed." These reforms would lower student debt as well as better equalize the salaries doctors earn, so that ultimately we would end up with more primary care doctors.

More primary care = better preventive care. And I think that dovetails nicely with the argument presented above.

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TheArse

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I am a Graduate Student of Public Policy and have previously done policy and economic analysis for a federal agency.

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