Monday, June 22, 2009

Hell frozen: a GOP columnist says something non-raving about health care

Ross Douthat is the NYT’s latest attempt to find a GOP-friendly columnist who’s not a raving loon.

He writes of health care today, and he’s only lightly raving …

Ross Douthat - The Hard Part -

…. In a world without political constraints, it wouldn’t be hard to create a fiscally responsible alternative. Conservatives would encourage people to self-ration, by putting a certain number of health care dollars directly in their hands and leaving the rest to market forces. Liberals would ration more directly, by slow-walking Americans into a public health care system, whose cost-conscious, evidence-weighing bureaucracy would pay for procedure X but not procedure Y, surgery P but not prescription drug Q.

But of course Americans want their health care system to bankroll the entire alphabet — and they definitely don’t want to think about “market forces” when they’re going to the doctor. They might be willing to pay slightly higher taxes to bankroll a reform, but their ideas about what “reform” should mean are far more expensive than what health care experts have in mind. Indeed, as William Galston noted recently, the best way to satisfy the public’s health care preferences would be to start with whatever the experts — right and left alike — say is required to keep the system solvent and do exactly the opposite…

Of course the choices are not as stark as Douthat pretends. He is a GOP voice, after all. On the other hand, my champion, Paul Krugman, isn’t as forthcoming as he might be. Krugman is very careful to skirt the reality of how health care services will be delivered -- if we actually win this one.

I’m 95% sure Krugman understands that what we will eventually guarantee every American is a ticket on the Manhattan subway, not the keys to a new Lexus. Everyone will get at least Quebec-quality healthcare, which is what I like to call “crummy care”. People with money will get what my family enjoys today, people without money get the Spartan version, and nobody gets “crappy care”. (As an aside, Subway Care may have better outcomes than Lexus Care, but that’s another post.)

Douthat is right that the average American’s ideas of “reform” are a delusion. Right wingers won’t mention that because they fear Obama will succeed – and maybe they hate that more than they love America. The good guys won’t talk about it because they suspect informed voters will freeze in the headlights -- and get squashed.

I’m not running for office though, so I can mention it.

No comments: