More on Health Care Efficiency

An update here on medical insurance with an inventory problem.

Depending on the condition being discussed, this can be a pretty serious matter and remedies are unclear. At the very least we are seeing the following as the solution:

1) Make a visit to an MD to get a prescription (cost of MD)

2) Visit a pharmacy and argue about insurance coverage (cost of administration)

3) Take much of a day off work (this is a cost to the employer via sick days or employee via needing to work longer hours to make up for this)

If these issues are frequent then the inventory control system is imposing a lot of costs on the system. Now, if this was a store (say Amazon) then it would be fighting to remedy these issues before it went bankrupt. But the lack of customer mobility is another area where Health Care is an unusual market.

Health Care

We haven't talked as much about Health Care lately, because I have been slammed by my first year of teaching. But I did want to highlight this post by Aaron Carroll:

You ready for this? They didn’t ship the medication. Why? It’s on back-order.

So explain this to me, awesome insurance system. You will only allow me to get my medication from one pharmacy, which is not local, and which you own and run. And you won’t send the medication early, which would provide a safe buffer. And then you run out of the medication. And then you don’t tell me until the day I run out. And then you don’t really tell me, you leave me a cryptic message on my voice mail that I would usually not be able to get until I arrive home and you are closed.

Will you allow me to go to another pharmacy? Sure. But you won’t cover it. Will you have the medication soon? Yeah, you hope to have it tomorrow.

I don’t believe you.

Do you have any concern – whatsoever – that I am without my medication for a period of time? That it’s entirely your fault?

I’m a model patient. I pay all my bills. I go to the doctor. I get the labs done. I refill the meds on time with a weeks’ advance. I follow the rules. And you screw me.

Are we really sure that the health care system in the United States meets the requirements for market efficiency*? Really?


* And, if you have not read the classic post by Mark Thoma then now is as good a time as any. Well worth the ten minutes to breeze through it and it is a very good way of evaluating whether a particular market is likely to be efficient.