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Politics : A US National Health Care System?
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To: John Koligman who wrote (16742)4/13/2010 8:19:47 AM
From: Lane31 Recommendation  Read Replies (1) of 42652
 
Out of Pocket Medical Expenses
by Jeffrey Miron on April 13th, 2010
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John Ford, a loyal reader who is an MD, submitted an op-ed to JAMA recently on the shortgage of primary care physicians. He received this comment from one reviewer:

If [the author of the op-ed] is suggesting that patients should pay more of their health care “out of pocket” I must object strenuously. Americans already spend a very substantial portion of their income for out of pocket medical expenditures. A 1995 Medicare survey indicated that Medicare beneficiaries spent 19% of their total income on out of pocket medical expenditures. No suggestion to “resurrect primary care” should come at the expense of the patient. (emphasis added)

The last sentence sums up a key part of the health care debate. Advocates of government subsidy do not want patients to bear the costs of their health care decisions. Opponents of subsidy believe the only way to restrain expenditure is for patients to bear at least some of these costs. Both views are consistent with the objectives of their proponents. The advocates of subsidy care mainly about redistribution. The opponents care mainly about efficiency.

By the way, check out this graph from John. It is easy to understand why health care expenditure is growing; fewer and fewer patients face meaningful incentives to economize.

jeffreymiron.com
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