Before the Federal Government Starts to Pay for Even More Healthcare (expanded)

Before the Federal Government starts to pay for even more healthcare shouldn't they attempt to remove incentives for state Governments to make healthcare less affordable?

Here is quote from Cato:

, further removing incentives for the states to make medical licensing and regulation more modern and rational shouldn't they remove some of the barriers to practice?

The federal government subsidizes demand for healthcare and the state governments restrict supply, which you would think would lead to higher prices.

Coincidentally as long as the federal Government is subsidizing demand, restricting supply is what you would expect state politicians to do if they were amoral ruthless maximizers for there states. (hmmm I do not think that they really are amoral ruthless maximizers but things tend to evolve is a biased direction). That the state politicians have an incentive to protect their Hospitals, Doctors and Nurses (maybe even insurers) from competition.

Here is an example of the AMA trying to keep completion from increasing.



As a case study, consider Utah is arguably the least corrupt state in the USA and healthcare sending in Utah is not that different from in the European countries that you mentioned (for schools also which USA spend more on). Washington DC on the other hand is off the charts. 



It is a state problem and should be addresses at the state level.
My solution to get the states to act is here.

Denmark Should Try to Get More Like the USA.

The USA is a great place for people to live Denmark should try to get more like the USA.

American Indians and Alaska Natives born today have a life expectancy that is 4.4 years less than the U.S. all races population (73.7 years to 78.1 years, respectively).

Greenland is part of Denmark. Greenland life expectancy 71 years, Homicide rate 19/100,000, compare with Puerto Rico life expectancy 79.4 yrs, and Puerto Rico’s homicide rate 18.5/100,000.

In Canada Life expectancy for Inuit in Nunavut for 1999 was 67.7 years for males and 70.2 years for females.

Almost a quarter (23%) of those 516 homicide victims were reported by police as Aboriginal, a group that accounted for just 5% of the Canadian population.

Teaching

From an article about training teachers:

Eric Hanushek, an economist at Stanford University, has estimated that during an academic year pupils taught by teachers at the 90th percentile for effectiveness learn 1.5 years’ worth of material. Those taught by teachers at the 10th percentile learn half a year’s worth. Similar results have been found in countries from Britain to Ecuador. “No other attribute of schools comes close to having this much influence on student achievement,” he says.
Rich families find it easier to compensate for bad teachers, so good teaching helps poor kids the most.

It is hard for me to imagine why that would be true.  He adds that if the average American teacher were as good as those at the top quartile the gap in test scores between America and Asian countries would be closed within four years. The above is also hard to believe does he assume a cumulative effect without diminishing returns?  

I had some bad teachers but I doubt that better teachers back then would make me smarter or significantly more knowledgeable now. I think that the low hanging fruit in schooling is to focus on what is taught, teaching the most important stuff, rather than trying to get students to learn more. Most of what is taught currently is only a signal for further schooling. Case in point the article seems to imply that in 4 years of college teachers are not taught how to teach! And that Ed majors are not flunked out if they do not show good ability to teach before graduation! That is alarming!

The article is self refuting. If schooling is signalling then the raising the quality of all teachers will have little/no impact, but if schooling is about human capital formation, how is it that after 4 years of college focused on teaching, teachers have not taught bee adequately taught how to teach! That Ed majors are not flunked out if they do not show good ability to teach before graduation would be considered alarming if college were about human capital formation! It would seem that that fact would be devastating to the human capital formation theory of schooling.

Student Loan Debt

An article on how to bring down college costs:

What’s really behind ‘free college’ and America’s student debt problem? A higher-ed Q&A with Jason Delisle

My additional idea:
One way to cut the cost of sending a child to University is to put the state funded Universities where the families live.

Tuition is already subsidized and financial aid has made it quite far up the income ladder so much of the debt is finance living expenses. University students being able to live with parents reduces that cost greatly.

Favelas are not so Bad

Favelas are not so bad.

Chuck Martel wrote:

There have been favelas in the US. See this in Park Bugle.

You may have noticed them here and there in the northwest Como area, small houses situated much farther back from the street than their neighbors. Some of these probably were the “garage homes” of a century ago, the idea being that their owners would build and live in them until they could afford a main house on their property. For one reason or another, some never got around to building the big house. Following World War I, St. Paul had an estimated 100 garage homes with one of the largest groups of them clustered around the Hoyt Avenue and Chelsea Street intersection. Technically, the homes were in violation of the city’s building code—a garage wasn’t supposed to be a long-term domicile—but times were hard and officials such as J.M. Clancy, commissioner of parks, playgrounds and buildings, tried to be understanding.“We have had unusual conditions during the war and after it,” he told the St. Paul Daily News in July 1921. “Regulations that might have been highly proper at other times might work injury to some people if enforced too strictly. “Most [of these people] are thrifty,” Clancy said. “Indeed, the very fact that they have the courage to take a small place like they do, is evidence of their desire to improve themselves. If some other people lived within their means, they would be better off.” C.A. Hausler, city architect, was in charge of building inspections at the time. He told the newspaper that he was trying to discourage the construction of garage homes, but acknowledged that there was only so much he could do “once a family has taken up its abode in one of the miniature homes.”To obtain a building permit, he noted, sewer and water connections were required. In that summer of 1921, a garage home had just been completed at Huron Street and Hoyt at a cost of $90 and two others were planned. And another home was under construction in a hayfield across Hoyt, even as the harvest went on around it.Albert Larson, a carpenter, owned one of the garage homes and his wife told the newspaper reporter that she liked it just fine. “We lived in a flat and paid $47.50 rent,” she said. “The landlord wouldn’t fix the place at all. It didn’t even have a cupboard. We moved out here and we like it much better. “We have one room, 20 x 20 [feet], and another 10 x10 [feet]. So we have lots of room. The material cost $400 and my husband did all the work,” she noted. “So, you see, our little home didn’t cost a great deal. And then it is all ours. That is something.”

If State Universities End Their Pursuit of Prestige

From over at Marginal Revolution

Steven Pearlstein wrote an article in the Washington post: Four tough things universities should do to rein in costs

He list following items:

Cap administrative costs

Operate year-round, five days a week

More teaching, less (mediocre) research

Cheaper, better general education

I think that the why of this is that University management is to intererested in raising the prestige of the University.  

In most fields there is not a shortage of PHD's and little of the Universities' prestige comes from its professors. So if they quit you replace them, if they go to other Universities you could get the experienced professors that they replace. 

I think that the state schools being subsidized already should ignore loss of prestige to some fairly low level and educate more students at lower cost. To be concrete target 20% increase in enrollment and 50% of the current per student cost. I think if you forgo prestige it could be done.

Maybe Germany Economic Policy Wise Should try to be more like the USA

Germany PPP GDP Per capita = $38,700.00 Ranked 17th. 
USA PPP GDP Per capita = $51,700.00 Ranked 6th. 
USA PPP GDP Per capita is 34% more than Germany. 

Maybe Germany economic policy wise should try to be more like the USA.

Before the Federal Government Starts to Pay for Even More Healthcare

Before the Federal Government starts to pay for even more healthcare shouldn't they attempt to remove incentives for state Governments to make healthcare less affordable?

Here is quote from Cato:

, further removing incentives for the states to make medical licensing and regulation more modern and rational shouldn't they remove some of the barriers to practice?

The federal government subsidizes demand for healthcare and the state governments restrict supply which you would think would lead to higher prices.

Coincidentally as long as the federal Government is subsidizing demand, restricting supply is what you would expect state politicians to do if they were amoral ruthless maximizers for there states. (hmmm I do not think that they really are amoral ruthless maximizers but things tend to evolve is a biased direction).

Utah is arguably the least corrupt state in the USA and healthcare sending in Utah is not that different from in the European countries that you mentioned (for schools also which USA spend more on). Washington DC on the other hand is off the charts.

It is a state problem and should be addresses at the state level.
My solution to get the states to act is here.

What Should Republicans do About PPACA

What Should Republicans do About PPACA

Because of loss aversion and because people (me for example) have changed coverage based on the law, they should take it slow and one step at a time and do the following:

• Remove the 3 to 1 rule. See here because with income subsidies I see no reason to force a subsidy of older people by younger people.
• Slowly each year raise the allowable deductibles until they get very high, like $30k per year or $250k lifetime. 
• Either fix or eliminate the employer mandates, by fix I mean, do not completely exempt part-time workers (maybe make employers pay a percent based on hours worked), and do not exempt employers based on the number of employees they have. 
• Allow insurers to create plans that only cover care with strong evidence of proven net benefits.
• Finally raise the penalty to where you are forcing most everybody to get health insurance.

Then think about how to get the states to eliminate regulations that drive up cost without providing proven net benefits.