How Not to Discuss Healthcare Reform

One might think that a post titled “Hillary Clinton’s Health Care Plan: One Way to Help Pay for It” might actually be about one way to help pay for Sen. Hillary Clinton’s health care plan but, if you did, you’d be disappointed. I was when I read that post on waste, fraud, and abuse within the current system, noting in comments that if you took the entire downfoot total of the scandals identified in the post and divided them by the number of years over which they were discovered and prosecuted it amounted to something like half of one percent of the annual incremental cost of the plan—an amount irrelevant to paying for it. The author, also in comments, responded rather tartly that of course the only way to pay for universal healthcare was through increased taxes and we’d better get used to the idea, darn it, adding that some of the costs might be defrayed through the savings realized through preventive care, an assumption of the plan made by Sen. Clinton herself.

That was one of the arguments made 25 years ago when HMO’s were legalized and at this point I think it’s safe to say that it’s an experiment that has failed. See also Susan Penner, Introduction to Health Care Economics and Financial Management which gives a handy history of some of the reforms in health care management over the years.

Hoisting the Jolly Roger, as the author of the post did, and announcing that the post itself was a sham is a pretty good example of arguing in bad faith. I would submit that’s one of the reasons for the lack of a meeting of minds between supporters and opponents of things like universal coverage, single-payer, and approaches to health care reform. Advocates of universal coverage suspect that their opponents are hard-hearted social darwinists while opponents of reform suspect that universal coverage is simply a stalking horse for a fully socialized healthcare system.

I’m all for universal coverage but unlike many proponents I’m a little stricter about relating ends to means and continue to take my “don’t raise the bridge, lower the river” approach. IMO by far the best way to achieve the benefits of universal coverage is to lower the cost of health care and health insurance to the point at which practically anybody who wants it can afford it and there are only two ways to do that: fiat pricing (remember that stalking horse?) and increasing the supply of health care greatly.

Anybody who’s taken an Intro to Econ course should know that fiat pricing won’t achieve the desired objective in the long term since it will tend to dry up supply. That’s why I’ve devoted so many posts here to the ways in which the supply of health care is constrained. That’s where our attentions should be and everything else is just temporizing.