I don’t doubt the good intentions of our government leaders, including elected officials and public health regulators, as they tighten restrictions on our freedom of movement.. We are “bending the curve” and easing the pressure on our health care system. But unless an effective anti-virus drug is found and administered to everyone very quickly, bending the curve will only delay the time before most of us will become infected, and will lengthen the time that we all suffer emotionally and economically.Why is our response to this situation so dramatically different than our response to the flu or automobile accidents? Both the flu and auto accidents kill tens of thousands of Americans each year and are preventable. We could dramatically reduce those deaths if we used the same extreme measures that we are using against COVID-19. But what is the point of living if we have to stay away from our family and friends? For a few weeks, fine. For several months or more, not acceptable. Life has risks. We need to balance the costs and the benefits of our efforts. Soon, we need to once again let people decide for themselves how much risk they are willing to take.
Sometimes, price gouging can be a good thing. If there is a sudden surge in demand for something, say face masks or hand sanitizer, is it better to keep prices low and encourage hoarding that can result in complete outages, or is it better to let prices go up as the market demand allows to discourage hoarding and encourage rapid increases in production? Why would businesses pay for overtime, or expedited shipping, or other higher costs to quickly increase supplies if they are not allowed to increase prices? There are certainly extreme situations where price gouging would be considered by most people to be immoral. (For example, it would clearly be immoral to charge $1,000 for a glass of water to a person dying of thirst when you have plenty of it.) But there are many other situations where allowing prices to go up significantly and quickly helps to make vital products available for important purposes to more people more quickly. Private efforts to keep prices low and to prevent hoarding in an emergency are to be commended, but be careful before you call for laws or regulations to prevent price gouging.
Thanks to Susan Voss for her thoughtful essay about the complexities of our health care system, and how difficult it is to reduce costs. (See link to Register essay below.) I don’t claim to have “the answer”, but I do suggest that the following cost saving ideas be given serious consideration.
- Medicare, Medicaid and private insurance should not be required to cover every new drug, product, or procedure that is approved by the FDA. Some are very high cost but provide only marginal improvement over alternatives that cost much less. Also, at least some covered products and procedures would likely be considered not medically necessary by most people.
- Consider shortening the amount of time that government grants a monopoly for patents. Patents are not natural property: humans have copied one another since the beginning of time. Our U.S. Constitution allows patents to be granted to encourage inventiveness, but there is no objective reason why a patent must be granted for 20 years. Why won’t five or ten years work? Maybe the length of the patent should be based on the cost to develop the patented item and whether or not government funds were used to help develop the item.
- Don’t require limits on out-of-pocket payments such as co-payments, especially for very high cost items. A person should have “skin-in-the-game” if they expect their insurance to cover very high cost items. Today, we see the opposite: drug companies offer to help pay people’s out-of-pocket costs so there won’t be so much political pressure on them to lower their prices.
- Allow both pharmacies and individuals to purchase drugs from sellers in other countries that are “deemed” to have sufficient safety procedures in place. If drug companies are free to charge lower prices in other countries, then pharmacies and individuals should be free to purchase the drugs from those other countries.
- Allow Medicare and Medicaid to negotiate with drug companies on prices they pay for the drugs that are covered by the programs. Right along with that, Medicare and Medicaid should be allowed to develop formularies (lists of drugs that are preferred over other therapeutically similar drugs), that give beneficiaries a financial incentive to use the preferred drugs and a penalty for using higher cost drugs.
Our health care wants are unlimited. Our ability to pay is not. We, as citizens, should not expect private insurance or our government health care programs to cover everything, regardless of cost. We should expect our government to NOT do things that increase costs, or reduce our choices.
On 12/16/2016, The Des Moines Register reported that the Iowa Public Information Board had ruled that Prairie Meadows Race Track and Casino was not a “government body” according to their rules and, therefore, was not required to follow open records laws, and not required to provide the Register with records pertaining contracts of its top executives. (See link below.)
The Register can appeal the decision, and has some good arguments why Prairie Meadow should be subject to open records laws. But even if Prairie Meadows is not required to follow open records laws, they could still release the records voluntarily. Just because it is legal to do something does not mean it is the right thing to do. Prairie Meadows would not exist if not for the original support of Polk County taxpayers. The board claims that Prairie Meadows is a not-for-profit organization, (even though the IRS disagrees). I don’t understand why any board member would want to be anything other than completely transparent about the operations of Prairie Meadows? I presume that none of them feel they have anything to hide.
I appeal to the board members of Prairie Meadows to simply do the right thing, and voluntarily open their records to the public, and the Des Moines Register.
Link to Register article: http://www.desmoinesregister.com/story/news/local/government/2016/12/15/iowa-board-says-prairie-meadows-records-can-secret/95492840/
The Register has called for payday loans to be outlawed. (See link below.) Just know, that if payday loans are banned, people who have a need for short-term small loans will simply not be able to get one – from any legal source. Using the calculated annual rate of interest is somewhat misleading. If a person borrows $500 for two weeks and has to pay back $550, the annual rate of interest is $260%. If the maximum allowed annualized interest rate was 36%, then interest on a two week loan for $500 would be capped at $7. No legal lender will make a $500 loan for 2 weeks to only earn $7. The Register quoted Democratic Iowa Senator Joe Bolkcom as saying, “In Iowa, they would be better off getting a loan from a loan shark.” If Iowa bans payday loans, we may find out whether or not Senator Bolcom is correct.