Scott Sumner is one of many to point the finger at the federal tax subsidy for employer-provided health insurance as a driver of high costs. I’m against this subsidy, I think it’s excellent that the Affordable Care Act rolls it back, and it’s clear that providing a large subsidy does contribute to high prices. Still, I think that too often people’s pet concerns about health care costs point to things that increase the level of health care spending rather than the high growth rate of health care spending.
Think about the market for cars. Cars are pretty expensive. They’re sold at a wide variety of price points. And quality-adjusted prices for cars don’t show any noteworthy crazy trends. Now suppose the government made cars tax deductible, what would happen? Well I assume that at the margin people would start buying more expensive cars. So for a few years, car spending as a share of GDP would accelerate. But pretty soon the American automobile fleet would have turned over and the acceleration would stop. The subsidy, in other words, provides a one-off boost to automobile spending but it doesn’t do anything to change the underlying cost structure of the system.
Health care, I think, is like that. But what’s really distressing people about health care isn’t the absolute level of spending, it’s the very rapid pace at which prices are rising.