At this point there are bills working their way through Congress that are being sold as healthcare reform bills although I think they’re actually nothing of the sort. Many of the advocates for healthcare reform seem to be hoping that everything that’s taken out of the bills to get them enacted into law will be put back into them later under the nonsensical belief, confusing causes with effects, that since we’re the only major industrialized country without universal coverage and we also have the highest per capita healthcare costs in the world that we have the highest costs because we’re the only major industrialized country without universal coverage. I heard the economist Paul Krugman say something along these lines this very morning on ABC’s This Week program. I gather that he subscribes to the well they just have to school of political philosophy, i.e. once we’ve done something fiscally insane we’ll take the steps necessary to make things right again because we just have to.
It’s hard for me to find the heart to post about healthcare reform as these ghastly bills make their way through the Congress and I’m feeling in a particularly grouchy mood. Is it my imagination or do a large proportion of the blogospheric advocates for universal coverage want somebody else to pay for their healthcare? It reminds me of Elbert Hubbard’s response to the charge that he was a socialist: When 51% of the people want to give rather than get, I’ll be a socialist.
One of the problems with our healthcare system is that too many people have their healthcare paid for by somebody else already. See also this earlier post. Is there any way that seventy or eighty percent of the people can have their healthcare paid for by the other twenty or thirty percent, costs can keep rising at the rate they’ve been rising for the last couple of decades, and everybody can get all the healthcare they want? I don’t see it.
I see that Megan McArdle is on a similar page to mine about the we just have to argument:
This is a terrible, horrible, no good, very bad argument in favor of more healthcare spending. It is true that as the immortal Herb Stein once said, “If something can’t go on forever, it will stop.” But, to belabor the obvious, there is more than one way to stop. This is sort of like saying, “I know I’m going eighty-five now, but it’s perfectly okay for me to press the accelerator here down to the floor, because after all, my current speed is already unsustainable.” One wants to know that one can stop with the brakes, rather than the trees decorating the sharp turn seven miles down the road.
People who aren’t worried about setting up a big new entitlement, because after all, we’re going to have to fix it eventually, are encouraged to read Paul Blustein’s excellent book on the Argentinian crisis, And the Money Kept Rolling In (And Out). Unsustainable fiscal policies can end when the government tightens its belt and raises taxes and cuts spending–or it can end when the whole thing melts down spectacularly.
As I see it the politics of this moves us towards meltdown rather than fiscal prudence.