NCPA - National Center for Policy Analysis


April 14, 2008

There is an immense volume of literature that expresses an abiding concern with the evident and persistent disparities in access to health care.  The usual approach to solving for these disparities is some new form of government intervention, usually by various kinds of forced access or subsidies regime.  Unfortunately, the chief consequence of these proposals will be, as it has usually been, to make a health system balkier and less responsive than it is was before, says Richard Epstein, a senior fellow with the Hoover Institution.

For example:

  • State-based medical licensing systems impose sharp restriction on the free flow of labor across state lines.
  • The Health Insurance Portability and Accountability Act (HIPAA) imposes numerous restrictions on the use and transfer of information which drives up the cost of medical care in the name of the protection of patient privacy.
  • A costly and unreliable medical malpractice system leads to the closure of desperately needed facilities that serve marginal communities.
  • Medicare offers huge subsidies for affluent seniors on the backs of people with a fraction of those affluent seniors' income.
  • Most importantly, perhaps, constant barriers are thrown in the path of nonmedical firms entering the market to supply health care.

Open competition will do more to lower costs and increase access than will the next generation of health care gimmicks that have such enormous, if unjustified, appeal, especially in an election year, says Epstein.

Source: Richard Epstein, "Health Care Disparities: Deregulation First, Redistribution Last," Health Affairs, March 13, 2008.

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