Pun Salad

This book is published by Cato, and written by two lawprofs: David Hyman (from Georgetown) and Charles Silver (University of Texas). The Kindle version is a mere $1.99 at Amazon. Incredible deal. Downside: it's very, very long: print version is 592 pages. Although the last 20% or so of the book is devoted to footnotes.

My immediate take: It's a good remedy for people who are advocating "Medicare for All". After reading this, you'll be saying (if you weren't already): Are those people out of their freaking minds? Because Medicare is seriously broken, rife with waste, fraud, and abuse. Maybe we should fix it first, before extending its breakage to the entire populace?

Yes, Medicare is "popular". Which is why Democrats find "Medicare for All" to be a winning slogan. But the authors show why it's popular: it doesn't ask too many inconvenient questions before shelling out huge sums of cash. Its income is silently deducted away in people's paystubs. And politicians love it because they get to run it and take credit for keeping the goodies flowing. Of course, as New Hampshire's own Drew Cline points out: it's due to run out of money in a few years, and politicians are diligently ignoring that problem. (One guy who wasn't: Paul Ryan. For his troubles, now an ex-Congressman.)

But it's not just Medicare, pretty much the entire market for health care is dysfunctional. The authors recite one horror story after another, showing how terrible things are. Most of the problem is due to the nature of third-party payments, where consumers are insulated from normal market price signals. The system can corrupt even honest people, who can hardly be blamed for responding to the incentives it presents. (People do so with varying degrees of eagerness, of course.)

The authors also have a bone to pick with "Big Pharma", which uses all the tricks in the patent book to protect its fat profits. The stories here might have you nodding in agreement with Bernie Sanders. The authors have some ideas about reforming the patent system for life-saving drugs, which may work. (Unfortunately, a lot of pols seem to be in Big Pharma's pocket, and those that aren't seem to be more interested in using the industry as a whipping boy for their own political gain, not

The authors are (surprisingly) optimistic about the future; they have visions that an increasingly expensive and inefficient market will give rise to more and more "retail" medicine, more medical tourism, and cheap insurance against "catastrophic" medical costs.

That would be nice, but I'm less optimistic when nearly all the politicians and all the mainstream media have bought into the narrative that's brought us to the current dreadfulness.

Anyway: an interesting (albeit anger-provoking) read, and (as said) a very good deal via Kindle.