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The myth of moral hazard and universal health care

Another analytical tool from the excellent PNHP:

One of the most pervasive myths in debates over health care reform is that of moral hazard the idea that when access to health care is unrestricted, patients “overutilize” health services in wasteful and inefficient ways. Opponents of single-payer say this overuse contributes to long wait times for care*. The moral hazard idea also underpins the arguments of supporters of consumer-directed health care and health savings accounts.

As these authors [Two studies -- PDF; PDF -- and Malcolm Gladwell in the New Yorker] point out, this dogma has no clothes. Beyond the common sense argument that going to the doctor is not a leisure activity for most people, there is compelling evidence both that moral hazard is both vastly overblown and a poor basis on which to formulate health policy. Empirical research shows that erecting financial barriers to care reduces as much necessary as unnecessary care, and the expectation that patients (especially the sickest 20 percent of the population that account for 80 percent of health spending) should be able to distinguish between what care is “necessary” and what is not is fantastical.

What shall I do? Play golf? Or go to the doctor?

Of course, both events are about equally likely at this point, but you see what I mean.

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Aeryl's picture
Submitted by Aeryl on

That people might use healthcare. Of course that's why they make it prohibitively expensive. I pay $190/mo for insurance, and I can't tell you the last time I went to the doctor and not been currently ill.

Damon's picture
Submitted by Damon on

I was just in an argument with a relative about this very subject a few days back where he was arguing that single payer would lead to unnecessary runs on the hospital that would end up breaking the system. **ugh**

On a sort of related note, though, I would like to see a larger focus put on prevention. It's something we don't talk about enough.