Common market in health care?
A top story in the UK this week was about a woman who went to France to have a hip operation despite the fact that her local NHS unit refused to pay, telling her the time on the local waiting list was reasonable. She took her case to court and it eventually went all the way up to the European Court of Justice in the Hague, which ruled that the NHS had to base its decision on medical need, not waitlist policy. (The articles were fuzzy on how the NHS decides whatÃ‚Â’s reasonable now Ã‚Â–I would have thought medical need somehow came into play.) In any case there is speculation that the decision will encourage other patients to be bolder in their assertions of whatÃ‚Â’s a reasonable wait time and may dramatically increase the number of patients going abroad at NHS expense.
Rather than treat this as a defeat, perhaps the NHS should consciously suppress the supply of certain specialists Ã‚Â–like orthopedic surgeons specializing in hip replacements– in the UK and encourage the development of surplus capacity in lower cost EU countries such as Poland and Romania. ItÃ‚Â’s super cheap to fly around Europe these days, so why not take advantage of the laws of comparative advantage (to the extent normal economic principles apply in health care) to bulk up certain services that need to be provided locally (e.g., heart attack treatment) and scale down others (e.g., hip replacements)?
It could be a nice growth industry for poorer countries Ã‚Â–kind of like the way countries such as Sri Lanka sign up for UN peacekeeping missions that are a money maker for them and take the burden off rich countries.May 18, 2006