Rejoinder to yesterday’s Medicare post

Yesterday I posted about a Wall Street Journal opinion piece by John Goodman of the National Center for Policy Analysis and today he’s responded to my post (see Pushback on My Medicare Proposals). John is blindingly optimistic about the prospects for free market policies in health care, and some of the commenters on the blog seem even more so. (One commenter seems to be referring to me as “the forces of darkness.” This would be a new low if I hadn’t previously been called a “commie”, “incompetent” and “parasite” when I pointed out we had waiting lists for health care in the US.)

I’m sympathetic to Goodman’s perspective. I really am. But based on my own experience working with and studying companies that make their living by boosting volumes for services paid by Medicare and private insurers, it’s clear to me that implementing Goodman’s proposals would only drive up Medicare costs further. The nature of supply and demand for health care services and the reality of third-party payment make Goodman’s simple solutions, elegant and attractive as they may seem, unlikely to succeed in their stated goal.