Tag: ezra klein

Procedural Difference

Ezra Klein toots:

There’s a difference between “we have the best health-care system in the world” and “I can buy the best health care in the world.”

Absolutely goddamned right there is. The sentence that usually comes out of the mouth of someone positing the “best healthcare” trope is one about some Sultan or Prime Minister coming here for a procedure. Nobody says that our capability to perform procedures isn’t among the best or the very best in the world. What we don’t do well, if at all, is fix somebody’s high blood pressure. Or monitor their diabetes. Or screen them for colon cancer while it’s fixable. You simply cannot do those things through the Emergency Room (where the “best healthcare” folks always point out you can receive free care).

It’s precisely these little things that markedly reduce life expectancy in this country, and concomitantly increase cost as the folks who haven’t been dealt with turn up and need incredibly costly end-of-life care. This is why we pay at least twice as much as the next nearest “Western” nation while getting remarkably worse outcomes across the board.

Invisible Hand

Ezra Klein puts this simple concept as well as I’ve yet seen:

Liberals don’t think that Congress will pass a bill outlawing private insurance. They don’t think the Supreme Court will render a decision naming WellPoint “cruel and unusual.” Rather, they think the market will, well, work: The public option will provide better service at better prices and people will choose it. Or, conversely, that the competition will better the private insurance industry and that people won’t need to choose it.

But that confidence rests on a very simple premise: The public sector does a better job providing health-care coverage than the private sector. If that proves untrue – and I would imagine most every conservative would confidently assume that that’s untrue – the plan will fail. The public option will not provide better coverage at better prices, and so it will not be chosen, and it will languish. Indeed, if it languishes, it will lack customers and thus lack bargaining power and economies of scale, and get worse even as the private insurers get better. In that scenario, the public option not only fails, but it discredits single-payer entirely.

The liberals are willing to bet that they’re right. It’s not a sneaky strategy: It’s an up-front wager. The conservatives are not, however, willing to bet that they’re wrong. They’re willing to say the public option will fail, but not give consumers the chance to decide that for themselves.

If we had a working government, maybe we’d get to try things, work for good policy, and ultimately get to the best outcome for the American people, whatever that might be. Why are the conservatives in this argument so afraid of The Market? What don’t they want us to find out?