Stephen Schaefer

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• September 10, 2009, on Health Care Reform:

  I'm highly skeptical of market solutions to health care, because efficient markets require the participation of well informed rational agents. Beyond basic recommendations (break addictions, exercise, maintain a healthy weight), the general public cannot be sufficiently informed to participate well in a health care market. People who are sick or injured (especially the mentally compromised) do not make optimal choices. As an example: I should get a colonoscopy in the next couple months; I've no idea what the cost/benefit comparison is between traditional and "virtual" (MRI) colonoscopies, so I'm going to do what my doctor tells me to. Individuals don't have the knowledge or means to appropriately reward or penalize doctors. The incentives for insurance companies are perverse - the faster a sick customer gets dropped or dies, the better for the company. Information about the performance of insurance companies is difficult or impossible to obtain, and they often hold an effectiv...