He'd have more of a point if he actually proposed some ideas for cost control, even if they were ones that most people mentioned. But, quite literally, we have nothing from him on how to do that.

Besides that, at least a few economists, like Jonathon Gruber of MIT, say it's more important to pass coverage expansion now and worry about cost control later.

I also think that Cowen falls into the trap that so many fall into: assuming that spending a particular amount on health care is bad. It's not, unless there's a lot of waste. And that's exactly the problem we see now: we are paying so much more than other advanced nations yet receive so much less. I don't think we should necessarily be concerned that costs go up by a certain amount, but instead be watchful that the money is being well spent. Nobody seems to think that's the case now.

Right on Dean. You crack me up. Feed them their dog chow from their own dish.

The high (initial) costs of the Massachusetts program has been supported on this very point by Krugman, et al, as a means to an end to accomplish reform.

Establish universal coverage first, then get costs down, as a political strategy.

Once coverage is established, particularly with the lure and hammer of forced mandates, it will be more difficult to remove it politically as a cost reduction measure, forcing reductions in other areas where they should have occurred long ago.

It reverses the usual "runaway cost" arguments with a bait and switch that lures in the service, then cuts costs later. It's like a Pentagon strategy but with real cost reductions.

The strategy may work over the long run, if for no other reason because health care affects everyone, which diffuses redistributive issues across users and focuses instead on the real problem, the supply side.

Yes, universal health coverage is a must---and then cost controls through strict regulation should come next. I wonder re.Dean's point how a bigger influx of expats into other national health systems would affect those systems? I spend a few months a year in Panama, where there's a decent attempt by a relatively poor country at providing health care access to all citizen (clinics, public hospitals, drug formulary,etc). Would (presumably) a flood of retirees wreck the system?

Allowing medicare vouchers is a good idea. But don't say "Tyler Cowen Is a Protectionist." without positive evidence. You hurt your own credibility.

"I might add I do favor taking action to lower doctors' wages in the United States. Letting in a greater number of qualified foreign doctors is step number one."

Tyler Cowen
http://www.marginalrevolution.com/marginalrevolution/2007/03/french_health_c.html

Also
outsourcing_med.html
medical-free-tr.html

Dean,

Excellent point, as usual. In fact, the UK was eventually forced by the European Court of Human Rights to do exactly what you propose. If treatment cannot be offered in a timely manner by the NHS, the local health authority has to pay the cost of allowing the patient to have the procedure elsewhere in the European Union.
Another point: what other country in the world has health care as a marginal cost of production for businesses? This puts US companies at a tremendous competitive disadvantage.

Absolutely right, Dean! I especially appreciate your point about letting Americans on Medicare go to other countries for medical treatment, and having Medicare pay for it. This is a truly creative, simple cost-effective approach to the problem of skyrocketing American health care costs.

Why is Dean Baker the only person who seems to be discussing this possibility in our so-called national "debate" on the health care payment system?

This is an idea whose time has come.

Most developed countries subsidize their healthcare system. Why would europeans be willing to extend this to americans? what about the added cost of traveling to these countries?