Arnold Kling argues that increasing the government’s role in health care, as Jacob Hacker recommends, amounts to Adding Passengers to the Titanic:
According to the 2006 report of the Medicare Trustees, the unfunded liability in Medicare over the next 75 years is $11 trillion. This is the gap between the promises that the system makes to future beneficiaries and the taxes that will be collected under current law to pay for those benefits.
Kling’s recommendations:
- We need rigorous cost-benefit analysis of medical protocols. For heart disease, when is bypass surgery the best solution, when are angioplasties the answer, and when is treatment with medication most cost-effective? Is screening for colon cancer using colonoscopy the best approach, or would other procedures be most cost-effective for lower-risk patients? The United Kingdom uses a commission of experts to undertake this sort of analysis, and perhaps we could use something similar.
- We need to rethink what it means to have health insurance for people under 65. The real need is for insurance against really expensive illnesses, of the kind that require tens of thousands of dollars of spending over a period of years. Discretionary care and minor expenses ought not to be covered.
- We need to examine options for putting Medicare on a sound financial footing. Ultimately, this will require changing to a system where people save more in personal accounts for the inevitable high medical expenses they will incur as they age.