Health care normal good or public good

[mileslunn]

For health care do you think it is something best left to private sector or best done by government and in your country describe how set up and whether you support more private or less private than currently offered.

Mine is Canada where for basic health care through Canada Health Act and provincial laws it is free of charge although can be delivered by either government or private sector (mostly former for hospitals mostly latter for doctor's) however private pay options are either heavily discouraged or banned outright.  Canada is sort of an outlier here as almost every other industrialized country has a small parallel private system in some form while Canada largely lacks this although some clinics have found loopholes to skirt this but ability to stay open requires governments are lax on enforcement thus depending on government of day.

At same time our overall private vs. public is close to OECD average since our system covers far less than most.  Things like dental care, eye care, prescription drugs are largely left to private sector unless you have a really low income.  Likewise even ambulances one must pay for while hospitals are free but private or semi-private room you usually pay cost of room but not treatment.  Unlike most in Europe generally no user fees or co-payments for doctor visits and hospitals although can charge them if not medically necessary like doctor's note for missed work but anything classified as medically necessary is supposed to be free of charge.

My view is that Canada should scrap the Canada Health Act and like other industrialized countries allow more private competition.  Duplicate private health insurance should be legal (banned in 6 of 10 provinces) while dual practice where doctors work in both private and public systems should be allowed but with minimum # required in public before can go private.  This is outlawed in all provinces but a few have got around it by working publicly in one province, private in another.  While not technically illegal to charge if a doctor opts out of health care, due to fear it will be banned this is very rare outside Quebec.  Only 7 doctors in BC have and 4 in Alberta while in other 7 provinces 0.  That is 0.1% of doctors in those two.  Only in Quebec is it somewhat common but even there it less than 5% of doctors.

Also user fees should be introduced for doctor visits but not hospital but should be no more than $10 and free for children, seniors, and those with incomes under 30K.  If free you have problem of moral hazard so even a small cost makes people think twice about abusing it.  Of G7 countries, Canada and UK are only two that don't have these while ones like France & Japan have small co-payments and deliver better outcomes.

Wondering what others thoughts are on this?  Also for any Canadians how come Canada is an outlier as I never could understand why private alternatives so taboo here even if perfectly acceptable in places like Nordic Countries who have much more extensive welfare states.

[Make Canada Boring Again]

Hybrid system is best, though Canada should have more coverage through it's public system than it currently has as well.

[Dr. MB]

public, like all goods

[Alcibiades]

I just want to say I find this thread title quite funny and odd considering the board it was posted in, because ‘normal good’ and ‘public good’ both have a specific meaning in economics, neither of which means what the OP is using them to mean here, and which are not in any sense diametric opposites.

[Skill and Chance]

I just want to say I find this thread title quite funny and odd considering the board it was posted in, because ‘normal good’ and ‘public good’ both have a specific meaning in economics, neither of which means what the OP is using them to mean here, and which are not in any sense diametric opposites.

Healthcare would at least mildly be a public good in economics because of contagious diseases, no?

[Benjamin Frank]

My view is that the problem associated with a private parallel health system is solely caused by shortages of health care providers that have been created by the government artificially limiting the number of health care providers (through limiting training spaces.)

It will take a number of years to increase the number of health care providers to the point where the private system can be fully up and running without not only not taking away from the public system, but assisting the public system by taking patients out of it.

This could be done by allowing those who want to invest in this private system to pay for the training spaces of health care providers for this private system.

I think there is a potential conflict of interest allowing providers in this parallel private system to also work in the public system, so any parallel provider would have to limit their practice to the parallel system, except, I suppose for those who have contracts with the government (which is actually what already goes on with things like physiotherapists.)

This artificial shortage of health care providers was caused by health economists in the 1990s who argued that 'doctors create their own demand which drives up health care costs, so limit the number of doctors and that will limit the increase in health care spending' (I'm not joking.)

Personally I think there is a limit to demand because I don't think people actually think "I'm going to get knee surgery I don't need because it's free" so I think that would place a limit on the amount of health care providers who would opt for the parallel system.

I'm sure many of the 'best doctors' would go for the private system (which would also serve to keep them in Canada and not go to the U.S) but, then again, what exactly is a 'best doctor'? (Outside of a handful of surgeons who are the only ones capable of performing especially complex or rare surgery.)

House M.D was a fictional T.V show.

[Alcibiades]

I just want to say I find this thread title quite funny and odd considering the board it was posted in, because ‘normal good’ and ‘public good’ both have a specific meaning in economics, neither of which means what the OP is using them to mean here, and which are not in any sense diametric opposites.

Healthcare would at least mildly be a public good in economics because of contagious diseases, no?

As you say, you can perhaps make the case that certain specific types of healthcare, such as vaccines, are somewhat non-excludable, because of e.g. herd immunity — though you’d still rather have been vaccinated yourself than not. But most types of healthcare are excludable; think of cancer treatments for instance as an obvious example. Regardless, healthcare is clearly rivalrous, so does not meet the other criterion required of public goods; there is a finite number of hospital beds, doctors etc.

[SnowLabrador]

Public good. At least, it should be, but I live in the dystopian hellscape known as the US of A.

[wnwnwn]

Its a normal good in theory, but that doesn't mean the goverment shouldn't invest in it.

[Antonio the Sixth]

It's a private good in the technical economic sense (rival and exclusive), but that doesn't mean it shouldn't be decommodified. There are many more valid rationales for decommodification beyond those accepted by orthodox economists.

[Electric Circus]

I don't know exactly what this thread intends to ask, in terms of the economic jargon, but "health care" - a term that includes everything from facility stays, to pharmaceuticals, to enforcement of public health regulations, to durable medical equipment, to the practice of medicine itself - is too many layers of abstraction removed from anything concrete enough to be worth classifying in those terms. 

[TrumpBritt24]

As I've gotten older and matured (and had experiences in dealing with medical bills and doctors appointments and antidepressants, etc.); I've come to like the idea of a public option more than Medicare for All; but I'd take either/or.