Friday, February 7, 2014

Oklahoma Senator Tom Coburn, a Physician, Is Guilty of Economics Malpractice

Proposal to Sen. Coburn:  We Won’t Practice Medicine, You Don’t Opine on Economics

The retiring Senator from Oklahoma, Tom Coburn is interviewed in the Wall Street Journal and talks extensively about health care economics.  As a physician, one might think Sen. Coburn knows something about the subject.  He doesn’t.

Mr. Coburn’s main point is that as a conservative Republican he supports market based decisions on health care by patients, such as a person being taken to an emergency room having to make a choice between the one that is close by and the one that is 10% less expensive and gives a coupon good for a free Big Mac with every admittance.  It would take far more space and be way to boring to fully refute Mr. Coburn’s erroneous analysis, and of course it would be nice if the Wall Street Journal actually published both sides of an issue, but everyone knows that ain’t gonna happen.

But what is interesting is this statement in the interview.

Dr. Coburn observes that "nearly all the economists agree" that a source of America's long-running health-care dysfunctions is the tax exclusion for employer-sponsored insurance only.

Well, actually no.  And even if a bunch of economists did agree on something, does that really make it valid.  Really, what has been the experience over the last 70 years from serious professional academic economists that would give anyone confidence in their conclusions?  No the real problem with U. S. health care costs is the fee-for-service system, something no other advanced nation has fore the majority of its care.

But there is one observation that can be made.  Almost all economists agree that Sen. Coburn knows nothing about health care economics (and most economists hope that Sen. Coburn’s personal health issued are resolved in his favor.)  And no, we cannot cite any sources for this observation, some things are just so obvious that we don’t have to.


  1. I think the market-based approach can be refuted simply. In the American healthcare system, most patients are a captive market because they cannot effectively negotiate among providers. The only entity that can effectively control costs is the insurance company, which has bargaining power and can refuse to pay medical fees that it considers unreasonable. When a patient is uninsured, he has no bargaining power and is forced to pay whatever the provider demands. Does that sound right?

    It's always remarkable when a Republican blames a tax exclusion for something. I thought Republicans believe that taxes are evil?