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Thursday, March 06, 2008
David Strom :: Townhall.com Columnist
The Planning Fallacy
by David Strom
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Imagine this scenario: an economist examines consumers’ automobile purchases and comes to the conclusion that the market is completely out of whack. By any rational measure consumers are making irrational decisions about what cars to buy, raising the costs of automobile purchases far above what is economically sensible.

Consumers could save huge amounts of money by buying the “best” cars based upon cost, safety, fuel consumption, and other criteria set up by experts. Better yet, by standardizing automobiles society could benefit from diverting enormous resources to other, more worthy social goods. Reducing the frequency of automobile purchases could save enormous amounts of money too, without significantly impacting mobility.

Only a few types of cars would be manufactured instead of the 340-plus models available today. Standardization would improve efficiency immeasurably. All cars would have interchangeable parts, all mechanics would be specialized in maintaining the few standard cars available, and drivers would never have to waste time figuring out how to turn on the lights or windshield wipers when we rent a car. Nirvana!

You can make this kind of argument with just about any product and easily arrive at the conclusion that the free market is wildly inefficient and should be replaced by the rational management of the economy by experts. After all, experts are better equipped to evaluate the costs and benefits of different products and optimize the results for all involved. A planned economy would be much more rational and fair than the wasteful chaos of the free market.

Of course this logic is built on pure fantasy: experts cannot adequately account for diverse consumer preferences; innovation will slow to a crawl as research and development gets centralized; and lack of competition will inevitably cause industry to stagnate and become increasingly inefficient. The history of socialist experiments bears these criticisms out.

Unfortunately it seems like this lesson is never learned, especially by the “experts” themselves.

The next wave of health care “reform” is driven by this logic. The solutions being peddled to an unsuspecting public include dramatically more government regulation, imposing “best practices” requirements on doctors and hospitals, and reducing the already restricted consumer sovereignty in health care.

The same surface rationality that would call for a state Bureau of Automobiles applies to the aggressive regulation of medical care. We hear constantly that our medical care is too expensive, of too uneven quality, and produces results far too poor for the money we spend. It is easy to marshal statistics which show that medical results in America are poorer than in our peer countries, despite much higher spending.

These statistics, though, are highly suspect for many reasons. Consider just one measure that is often used to prove the superiority of socialized systems to the American health care system: infant mortality. In the United States medical teams almost always try to save every baby, regardless of its chances of survival; in many “advanced” countries babies are counted as stillborn if their chances of survival are deemed too low. Hence the US can simultaneous save more babies’ lives while appearing to have a higher infant mortality rate.

In comparing apples to apples you get a much different picture. Statistics like infant mortality and lifespan are poor measures of the health care system, because they measure many variables in one overall number (average life spans, for instance, are influenced by murder rates, car accidents, risk-taking behavior, diets, genetic variables, etc.). If you compare medical care to medical care, the U.S. system looks considerably better.

Consider cancer survival rates. If you examine five year survival rates in the United States versus Europe, a startling fact emerges: Americans have far higher 5-year survival rates from cancer. Among women the 5 year survival rate for Europeans is only about 90% of America’s. Among men the difference is stark indeed: European men have only 71% of the 5-year survival rate as American men. American health care starts to look pretty good.

And measurable outcomes are only one component of consumer satisfaction, which should be the goal of health care providers. Just as with other kinds of consumer products, it is impossible for a panel of experts to define what is “right” for consumers, no matter how precise their data or how sophisticated their models of what we “ought” to want. Government planners are no better equipped to manage and regulate our health care system than the supply and demand for automobiles.

Just as in other areas of life, there is no “one size fits all” model of health care provision.

There is no doubt that our current health care system needs reforms, largely due to the enormous government intervention already present in the system. Government directly pays for about 45% of health care expenditures, and influences the totality of spending through tax subsidies of third-party payer systems. These interventions distort our health care spending enormously.

The solution, though, is not more government intervention in the system, but less. The logic of consumer sovereignty which works in the automobile, housing, food, and consumer products sectors of our economy should be applied as well to the medical sector as well. Freer markets really are the most effective way to increase consumer satisfaction.

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About The Author

David Strom is the President of the Minnesota Free Market Institute. He hosts a weekly radio show on AM-1280 "The Patriot" in Minneapolis-St. Paul, available on podcast at Townhall.com.

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Well put
Excellent article. Only gripe I have, and I'm sure Strom would agree with me anyway, is that even if government were magically more equipped to handle our healthcare than we are (which is certainly has demonstrated it is not) it still would not fall into its sphere of influence: the purpose of government is to protect life, liberty, and property, not provide.

What's taking Lilly so long to respond? Where are you Lilly, I can't wait for you to regurgitate some liberal "Sicko" talking point about the perils of market-led healthcare...

Choice
When I first moved up here to Kanukistan, I grumbled to my friends from Buffalo about the lack of choices in virtually every product. (At that time there was only ONE brand of baby food sold, for example, by fiat ruling from the State). Choice, I was told, frightens people. They become confused and paralyzed if faced with more than one option.

My friends from Buffalo, who are lefties, were confused by my frustration. "Why do you need thirty brands of soap?" asked one of them scornfully.

"I do not need 30 brands of soap," I explained. "I NEED THIS BRAND."

Consequently I have discovered that the Seven Words of Canadian Shoppers are I WILL BUY IT IN THE STATES.

Socialism only works if you are right next door to Capitalism, and the borders are relatively open. (However, subterfuge is required to have stuff shipped in without doubling the price.) That is why Canada is effectively 3000 miles long and 120 miles wide.

Silly Mr. Strom - you are following
the wrong model. Universal, government-run health care is not about consumer satisfaction, but about politicians' satisfaction.

Government and "experts"
"...it is impossible for a panel of experts to define what is “right” for consumers..."

These words should be tattooed onto the eyelids of every politician, bureaucrat, and liberal in the United States. (When we've finished with them, we'll do the rest of the world.)

As the commenter above noted, when it comes to government intervention in the market, the overt reasoning is almost never sincere; the real motivation is almost always power. If enough Americans were to grasp that bit of wisdom, we'd have our Constitutional republic back in a jiffy.

My favored definition of an "expert" is "a person telling a politician what he wants to hear." Compare that to the behavior of the "experts" you've observed at close range!

Toilet paper in the USSR
One of the items whose production was restricted to one brand in the Soviet Union, was toilet paper. As a direct consequence of that, toilet paper was also amongst the most highly prized, and highly priced, items on the black market. Central planning in the Soviet Union created the Russian mafia, who now govern that pathetic nation, Russia. The only way a criminal enterprise could exist in the USSR was under the wing, or with the active participation of, the various secret police organizations, from whence came the estimable Mr. Putin. Paraphrasing JFK, if you make freedom of choice illegal, you succeed only in criminalizing the citizenry at large.

What's so depressing about all of this is that the irrefutable, objective truth of it still needs to be defended! Arguing against these self-evident truths, as indulged in by approximately half the American public, is a constant source of wonder and depression for me.

In the furtherance of their lust for power over their neighbors, those who indulge in this pernicious belief have seized on global warming as their latest vehicle for seizing their neighbors' property, sanctimoniously declaring that "the debate is over". Meanwhile, in one of the few empirically demonstrable areas where the debate can truly be declared over, i.e. the abject 100% failure rate of socialism, they want to keep debating! At my advanced age, I can afford to be merely fascinated and depressed by it, but you young folks out there... you're screwed!

Smirk
It doesn't matter how many times, or how hard, you slap collectivists in the face with the evidence of the fallacy of central planning, they still cling to the illusion that it can work if only the right people were in charge - namely them.

Then they wonder why anyone with even a basic understanding of economics holds them in such humorless contempt.

Price Controls
Most health care can be made more affordable with price caps on medical procedures.

dbz77
One reason that health care is so expensive is that doctors and hospitals are practicing defensive medicine to protect themselves against lawsuits. They take batteries of tests to ward off the possibility of missing a diagnosis and getting sued yet again.

A person can go to the emergency room to get a broken leg set and then two months later sue the attending physician and the hospital for failing to diagnose his lung cancer.

Omniscience comes at a high price.

An answering ad...
What lies below is speculation on my part, however there is no question in my mind that with a little research both examples can be found in real life:

A Hillary Care Ad I’d like to see (but never will because Republicans are spineless)

Stage Direction: Camera focuses on a little girl and an announcer begins the monologue…

This is Cindy, she suffers from (insert life threatening illness here). Her father has health insurance provided by his employer, but… the life saving surgery Cindy so desperately needs is not fully covered by this insurance plan.

Cindy’s father faces a tough financial decision; should he take out a second mortgage on his home to help pay for Cindy’s badly needed surgery?

In desperation Cindy’s father borrows heavily and places himself in financial peril.

Stage Direction: Insert new picture of Cindy

Cindy is on the road to recovery today, but her family faces financial turmoil, her parents are uncertain about the future, they may have to sell their home, they may end up living someplace rented again.

Cindy’s father says this is totally unfair!

Stage Direction: Picture of new little girl

This was Sandy, she suffered from (insert same life threatening illness as Cindy here). Her father has the single payer health plan offered by the Government of the country in which they live.

When told that Sandy was in need of the very same life saving surgery that Cindy required her father had NO financial decisions to make at all, in fact the only choice he was offered was to put Sandy on the waiting list for her desperately needed surgery.

Sandy’s father faced no dilemmas, at all he immediately placed Sandy on the waiting list.

Two months before Sandy’s surgery was scheduled to occur she passed away.

Sandy’s Mother and Father faces no uncertainty what so ever.

They know their daughter is dead!

Stage Direction: Show picture of Sandy’s grave

Auto to Health
Aside from the fact that your analogy is silly, you denigrate the public intellect once again. We are unsuspecting huh. Must we remind you again and again and again, we don't have the power. It is NO LONGER, we the people. Once in a great while within the past 9 - 10 years or so, with the aid of traditionalists, we the people have enforced what is ours, but only with legal assistance. We keep paying for our constitutional rights over and over and over again. It's not going to change. Get a grip on reality. Have you heard, California favors teaching communism. We do hope you know that communism advocates the overthrow of our republic. As goes CA, so goes NY, so goes the squeeze toward the middle. Your column is consistently superficial. Congratulations!

Shalom

Proof that government causes high $$$$
All you have to do to see that less regulation and less government mandates in coverage works is to look at how the cost of lasik eye surgery and cosmetic surgery costs have decreased. In areas where government has not mandated insurance coverage- the costs continue to decline. Much like most of our technology- items that are popular, like PCs and Ipods and cell phones just continue to get better and cheaper.

Free market dogma past its due date
The seductive aspect of any dogma is that for any problem, there is a solution - and a simple one at that.

Nothing could be more dogmatic -- or simplistic -- than free market libertarianism. Throughout history, time and time again, we've witnessed the dangers and shortcomings of the unregulated free market, and time and time again we've been burned.

Just this week, Treasury Secretary Henry Paulson admitted that deregulation of the financial markets has failed us all. The following is from MarketWatch, published March 13, 2008:

"You know things are very very bad on Wall Street when a guy like Henry Paulson -- Treasury secretary, solid Republican, and former Goldman Sachs CEO -- joins the crowd calling for more regulation over the financial markets.

Paulson spared no one in his criticism Thursday of the excesses of deregulation that has now created the worst global financial crisis in a generation, threatening the health of the U.S. economy, the savings of millions of Americans, and the survival of some of the biggest financial institutions in the world. See full story.

Wall Street and Washington both failed big time, he said. Wall Street invented new ways to make money by selling securities so complicated that no one could really follow which shell the pea was under. Fortunes were made on the paper Wall Street sold.

At the same time, Washington's watchdogs were dozing, tranquilized by the false assurance that Wall Street would police its own ..."

I'll conclude with Albert Einstein's definition of insanity: "doing the same thing over and over again and expecting different results."
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