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Email the webmaster at econlib. A valid email address is required to post comments on EconLog. I think there is little dispute that, in a nation of million people, society-wide there is little connection between overall medical expenditures and overall health. The problem is that for a small percentage wise group of people every year, there is a huge correlation.

They will be very sick or die and no amount of moving to a rural area or exercising will change that. Only significant medical intervention will. Figure 5 to that report has a nice breakdown about where the healthcare dollars go. No surprise, the elderly per capita incur twice as much cost as the middle aged and several times more than younger people.

The sporadic and unpredictable nature of large healthcare expenditures is why an insurance model has always had a basic logic to it as applied to healthcare payments, very analogous to casualty insurance — the need for significant payments is rare but when it happens, urgent and significant. What is unfortunate is how many non-serious illnesses and procedures have been thrust into the insurance model, first by employers trying to retain workers during a period when the demographics made such promises cheaper than wage increases, and then by political forces distorting the insurance model into a day to day entitlement, while demographic and technological changes have made the entitlement grow far too expensive.

Slow and gradual increase in copays, deductibles, and exclusions of procedures would be fairer as a means of accomplishing a balancing. Realistically, that is all coming. The demographics essentially compel it in a slow-growth economy. All the other definitions include everything from pollen reporting to weight lifting, way more than can be cast in any coherent model. I think some of you are missing the point. You just need to cut!

Yes, it would be nice if we had some benevolent omnipotent god, or Hillary Clinton, to decide what is good and what is waste. That would be a free lunch. But absent that, just cut it. I think that we are well into the range of opportunity cost with health care.

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The only places that are building are hospitals and medical buildings. It is because they do make a serious attempt to evaluate the usefulness of various medical procedures — something the US does not do. Now that you have started to accept this point or from your perspective the facts have changed do you think you might temper some of your views on what should be done to change the US healthcare system.

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Their is a wealth of evidence to the contary and virtually no evidence to support your contentions. The democratic candidates actually take the position that we can save enough from eliminating waste to spend the saved money on people who get inadequate healthcare. If we get a single payer system that rations care, there will be a second American revolution. I am completely serious.

Most visits by salesmen are wasteful; they do not result in sales. Most police patrols are wasteful; no criminals are caught.


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Most fireman waste their time sitting around in firehouses. Stairwells in buildings are wasteful; they are mostly empty. My PC is a times more powerful that that old mainframe, and mostly my PC is idle, its time and power is wasted. Thank goodness. Only very poor societies cannot afford to waste anything. How often are they ordered because their convenience bumps them up in the diagnostic decision tree? How often do high levels of radiation associated with these tests cause malignancies later in life? Are these actions wasteful? Take, for example, colonoscopies. Yet asymptomatic people pay all those costs and risk perforated colons to get these done to them.

First, they want their cancer treated, if they have it. Ironically, this welfare gain may stem from reversals prior welfare loss that stems from knowledge acquired through research and diseminated via public health campaigns ignorance can be bliss. Would the addition of the direct monetary cost tip the balance of the decision?

Sometimes yes, sometimes no. I am merely arguing that a health policy wonk cannot focus only on medical outcomes when making an argument about whether procedures, treatments, and consultations were untaken with an expectation of positive utility.

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And with increasing frequency we are undertaking medical procedures not to directly improve the health status of the individual, but to acquire information. The value of this is highly idiosyncratic and difficult to evaluate statistically. Yet, ignoring this ignores the value of many consultations, tests and procedures. That will no longer do. It is time for the Second Amendment to enter full scale into the consciousness of the legal academy.


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  • Elsewhere, my colleague Tim Lynch links to reviews of several works that followed. One of the more interesting contributions to this line of scholarship is an article by Prof. Robert J. Our serious thinkers have been absent from this debate for too long. The Second Amendment is simply too important to leave to the gun nuts.

    The majority opinion in Parker v. District of Columbia is evidence that serious scholars heeded that call, a good summary of the debate over the Second Amendment, and a lesson about how honest, careful scholarship can defeat a very appealing myth. The release of Reason senior editor Brian Doherty 's Radicals for Capitalism: A Freewheeling History of the Modern American Libertarian Movement — the first comprehensive history of its kind — provides a fitting occasion for libertarian reflection.

    How did libertarians get to where they are today?

    Where are they going? How should they proceed? Drawing on his book, Doherty kicks off the new issue of Cato Unbound with a lead essay reflecting on the miracle that libertarians are politically and culturally relevant at all, while promoting a continued laissez faire attitude to libertarian strategy. To showcase the high art of libertarian in-fighting, we've gathered a panel of libertarian luminaries including: Cato Unbound 's own Brink Lindsey , author of the controversial " Liberaltarians " essay in the New Republic ; George Mason's most famous blogger-polymath, New York Times Economic Scene columnist Tyler Cowen ; Cato's globe-trotting ambassador for liberty Tom G.

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    Palmer , who was writing libertarian political theory as a zygote; and Atlantic columnist, former Reason editor in chief, and author of The Substance of Style , Virginia Postrel. Stay tuned over the next two weeks as our very special conversation on the future of libertarianism unfolds. The Wall Street Journal reports:.

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    The big drinks makers now plan to disclose the caffeine content on the product label. The new information will allow consumers to compare the caffeine content of various soft drinks and comes as beverage companies are introducing new supercharged drinks While health groups laud the move toward more labeling, some worry the caffeine disclosure might be used to encourage more caffeine consumption. Jacobson, executive director of the Center for Science in the Public Interest, who has lobbied for caffeine labeling by soda companies.

    Yes, there's always some possibility that when you give people more information, they'll still make their own choices. Some people consider that the nature of a free society. Others consider it a good reason to impose more and more restrictions, until people do as they're told. No doubt we'll soon find out which category includes Mr. The Hill reports on a senator's curiosity about groups:. My exposure to them is necessarily limited, as it is for most members. She is just curious, eager to learn. Political Philosophy.