Murdering Grandma does not substantially save on health costs

All the intellectuals in the US who are officially deemed to be very smart people are officially telling us that the big problem with health care, the reason your Obamacare bills are going out of sight, is that keeping Grandma alive for a few months longer can cost unlimited amounts of money

As you doubtless know, most government health care systems around the world wind up murdering Grandma to free up beds: “Prolonged deep sedation”; “The Liverpool Care Pathway”.

To rationalize this, as we in the US increasingly move towards a government healthcare system, everyone is telling us that grandma is causing out of control health costs.

People 65-79 (9 percent of the total population) represented 29 percent of the top 5 percent of spenders. Similarly, people 80 years and older (about 3 percent of the population) accounted for 14 percent of the top 5 percent of spenders (Chart 2, 40 KB).² However, within age groups, spending is less concentrated among those age 65 and over than for the under-65 population. The top 5 percent of elderly spenders accounted for 34 percent of all expenses by the elderly in 2002, while the top 5 percent of non-elderly spenders accounted for 49 percent of expenses by the non-elderly.

But what all that adds up to is that grandparents dying of complications of old age are causing only a small proportion of total health care costs.  The article whines about how selfish grandma is for expensively remaining alive, but reveals that grandma is not in fact costing enough to make a noticeable difference. If in each year you kill off the most expensive five percent of over sixty fives, you save twelve percent.

A casual glance around the emergency room suggests that the main cause of out of control health care costs in the US is people who can freely demand health care without facing any risk that they will have pay for it, that the major factor influencing health care demand, is not age, but whether one has to pay for it out of one’s own pocket, that a young healthy person for whom health care is free, demands a lot more expensive health care  than an elderly person for whom health care costs money.

On casual and unscientific observation, looks like affluent white people are paying for most health care, and underclass and non asian minorities are consuming most health care, looks that married people are paying for health care, and single women are consuming health care, rather than young people paying for health care, and elderly people consuming most health care, that health care in the US consists of massive transfers from whites to non whites, and substantial transfers from males to unrelated single females, most of them indios.

But since the evidence of one’s own eyes is horribly racist, sexist, and homophobic, let us see if we can find some scientific and statistical evidence for this.

In Singapore, they have prices for health care, and even when these prices are set by the state in government health care facilities, they are not too far from market prices. Almost everyone everyone has to pay these prices, or some substantial part of them, except for catastrophic health care.  Almost everyone in Singapore has catastrophic coverage, but has to pay for normal health care themselves, in whole or substantial part.

Singapore has quite a lot of government intervention in health care, so some people point to Singapore and say “See, capitalist health care works”, and other people point to Singapore and say “See, socialist health care can work”, but the big difference between Singapore and most other countries is incentives:  That most health care in Singapore is paid for by the person receiving it, that health care in Singapore is, for the most part, paid for by the customer, and that doctors therefore answer to the customer, not the bureaucrat.  He who pays the piper, calls the tune.  If Singaporean healthcare is more capitalist than that of the rest of the world, this is an almost accidental and perhaps unintended consequence of the fact that people have to pay for it themselves.

Grandma dying of cancer is the same problem in Singapore as under socialist health care systems (she and her doctors are tempted to run up excessive bills) since most people in Singapore have catastrophe insurance, but with regular health care, people only pay for if it is worth the price.

Guess what.  Singaporeans, having to pay for health care from their own pockets, do not buy much health care at all, and despite that, have very good health outcomes.  That total health care expenditures in Singapore are remarkably small indicates that Grandma dying of the ailments of old age is not the problem.  The problem is incentives for young healthy people, for that is the big difference with Singapore.

Since Singaporeans get good health outcomes, they are not underconsuming health care.

Therefore people in other countries are overconsuming health care – which is what we would expect if health care is free or heavily subsidized.

In some countries, health care is free for everyone, and I suppose that most people overconsume, though those with the most free time, the unemployed, the underclass, and the retired, probably overconsume the most.  But most of the time, in most countries, and in particular in America, it tends to be free for some people rather than others – for the poor, for non asian minorities, and for unmarried women, and so we should expect most overconsumption to be by such people.

And that is what I seem to see when I go to medical facilities in the US.

Grandma having an incentive to spend irresponsibly is not a significant part of the problem. The problem is beggars, gypsies, liars, cheats, tramps and thieves.  The problem is gimmiedats.

What makes healthcare expensive is the gimmiedats, not Grandma.  And proof of this is that when, as in Singapore, you continue to indulge Grandma, but you don’t indulge gimmiedats, healthcare costs a lot less.

In Britain, the NHS murders your grandmother to save money, but gives the man who thinks he is a woman a free sex change. In Singapore, they will not murder your grandmother, and will not provide a free sex change. Which place is more successful at reducing health care expenses?

If health care costs are such a problem that we need to murder people, let us murder gypsies.  Saves a lot more money than murdering grandmas.

Whenever one of the officially smart people tells you that the problem is old folks, he is saying “Let us murder your Grandma for your own good.  It is going to maximize utility.  You will love it.”  I say, kill the gimmiedats.

If we are going kill elderly people and eight month fetuses because they are expensive and inconvenient, I have a long list of people who are a lot more expensive and less convenient.