Unintended. But Predictable.

Bloggers of a libertarian bent, are you ever at a loss for ideas? Try searching the Google News for "unintended consequence". New blog-fodder every day. You're welcome.

Today's example is from the New York Times, an article with the headline "In Massachusetts, Universal Coverage Strains Care". Our phrase shows up in paragraph four; I'll also quote paragraph three for context:

In pockets of the United States, rural and urban, a confluence of market and medical forces has been widening the gap between the supply of primary care physicians and the demand for their services. Modest pay, medical school debt, an aging population and the prevalence of chronic disease have each played a role.

Now in Massachusetts, in an unintended consequence of universal coverage, the imbalance is being exacerbated by the state’s new law requiring residents to have health insurance.

[Emphasis added]

It's a "good" article, in the sense that it's well-written, with multiple interviews diligently reported. But on the other hand, I found myself wanting to give the reporter, Kevin Sack, and most of the people he interviewed, a moderate whack upside the head with a clue bat.

The article's hook is provided by Dr. Katherine J. Atkinson ("Dr. Kate"), a family physician based in Amherst, MA. She's got a long waiting list for accepting patients, and—even if you are a patient—her next scheduled opening for a routine physical is in May of 2009.

At the end of the article, Dr. Kate reveals her dissatisfaction:

“I calculated that every time I have a Medicare patient it’s like handing them a $20 bill when they leave,” she said. “I never went into medicine to get rich, but I never expected to feel as disrespected as I feel. Where is the incentive for a practice like ours?”
Hmmm, incentive. Where have I seen that word before?

Gosh, if only there were some sort of system to more efficiently allocate economic resources to where they were most demanded, and to provide incentives for people who provide goods and services to people who want them!

Well, yeah there is. Nobody in Amherst is approaching the local butcher at a ballet recital, begging to be put on his waiting list for pork chops. If an Amherst resident wants an iPod, a hammer, diapers, gasoline, …, pretty much whatever, he or she can get those things today, not schedule an appointment for them to be provided more than a year in the future.

But the good people of Massachusetts decided not to go that direction for medical care. They took a field already unusually awash in government regulation, licensing, red tape, price controls, subsidies … and they then decided to throw in some more, ushered in under the mantra of "universal coverage."

Predictable (but of course "unintended") consequences: shortages, queues, and (as typified by Dr. Kate) resentment.

Nobody in the article seems to know what to do about this, other than more of the same tinkering-at-taxpayer-expense:

Here in Massachusetts, legislative leaders have proposed bills to forgive medical school debt for those willing to practice primary care in underserved areas; a similar law, worth $15.6 million, passed in New York this week.
The single feeble nod to anything resembling a free market reform:
Massachusetts also recently authorized the opening of clinics in drug stores, hoping to relieve the pressure.
Bay Staters, rejoice! It's now legal to do something that never should have been illegal in the first place! Huzzah!

A number of candidates are promising to bring Massachusetts-style "universal coverage" to the rest of us. If that happens, bet on a big upswing in the "unintended consequence" Google hits.


Last Modified 2012-10-12 9:26 AM EST

Who Could Imagine?

When the minimum wage was increased, some predicted that employers would react by cutting jobs, and cutting hours for those who remained employed. At Cafe Hayek, Russ Roberts relates a yarn Hillary told Jay Leno on the Tonight show:

I was in Indianapolis the other day and I was shaking hands after I spoke. And there was this young boy about eleven years old and he's trying to tell me something—you know the crowd was yelling—so I leaned over and he said, "You know, my mom makes minimum wage and even though it went up, her hours were cut. So we're not making any more money. Can you help her?"
If you're thinking: "I bet Hillary didn't take away the obvious lesson from that", you're right.

(If your first thought was, instead: "I bet Hillary made that up," well, you're probably right about that too. I think she's learning, probably too late, to make her anecdotes as unfalsifiable as possible.)