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文章標題 Book : The Great Stagnation
How much IS health care really worth?
Not many people go to the doctor to enjoy his or her office, to
taste the pills, or to sit in the waiting room. A lot of us dread it.
We go to the doctor because we hope it will make us healthier.
The doctor doesn’t face the same market test as the apple does.
We know right away how good the apple tastes, and if it’s bad,
we’ll stop buying that brand or stop buying from that store. On
the other hand, very often we don’t know for a long time, if ever,
what the doctor did for us. In other words, the market is testing
whether or not the doctor can give us hope and the feeling of
having been taken care of, not whether the doctor really makes
us healthier. Feeling more or less hopeful is a pretty inaccurate
test. Hope is even supposed to be a bit irrational.
There’s another reason why the market test for medicine is not
such an accurate one, namely the prevalence of third-party
payment, whether through governments or insurance
companies. The person who chooses the doctor and the care-
the patient-doesn’t have to pay for most of it. That makes
medicine one big step removed from a real market test. You
might think it has to be this way, but again that means a lot of
money will be spent on health care for no good reason. You also
might think that the insurance companies would regulate the
flow of reimbursement to make sure it is spent only on good
doctors and good procedures. For whatever reason, insurance
companies find this hard to do (sometimes it is argued that the
major hospitals have too much monopoly power) and again that
weakens the power of the market test in the sector.
If you look at the numbers, what do they show?