Poisoning the Well

Have you ever noticed how one egregiously incorrect assertion can poison an entire article for you? In the case of this article by Paul Demko at Politico about “Medicare for All” it was this statement:

Some Democrats use “Medicare-for-all” as shorthand for a single-payer health care system, like the British National Health Service.

The problem is that British National Health isn’t just a single-payer system. It’s full-on socialized medicine in which the government is not only the primary disburser of payments for health care services it actually runs the system the way the Veteran’s Administration runs the system of VA hospitals.

The rest of the article is completely speculative. I won’t even comment on it.

I’m skeptical about M4A because I don’t think the conditions that would make such a system work prevail here. We are too large; we are too diverse; we don’t have enough social cohesion; we don’t have enough respect for authority. We aren’t willing to control costs so they would rise out of control, destroying everything else funded by the government in their path. That’s speculative, too, but at least it’s based on experience, cf. SGR.

7 comments… add one
  • steve

    ” at least it’s based on experience”

    At present we are unwilling to control costs. There are at least some reasons to think M4A might work. In every other OECD country with quality medicine having everyone in the same system seems to help result in lower costs. At present, no one even wants to touch Medicare spending (note Trump promising, LOL, that he won’t touch Medicare) because the old folks actually vote. With everyone in the same system, old folks vote is less consequential.

    If we don’t have the social cohesion for M4A, remembering that Medicare itself is actually pretty popular, then I doubt that we have the social cohesion, and maybe more importantly political will, for any other plan.

    Steve

  • Do you think trust in authority is rising or falling? I think it is falling. For Medicare for All to work people will need to take what the authorities dish out and like it. That has been true in every country that has adopted such a system. It is a prerequisite for cost control.

    You are making an argument for time inconsistency. Why, when faced with the same alternatives and same incentives, will politicians behave differently than they have behaved in the past?

  • steve

    It is falling, but Medicare still polls at 75%-80% popularity. Only Social Security consistently polls better. Look, there is no chance M4A gets passed, I am just saying that it might actually have a chance to work. If passed you have to assume that there would be some attempts by the GOP to sabotage it, but they would have to e careful because they would then risk hurting old people, the ones who vote for the GOP.

    ” Why, when faced with the same alternatives and same incentives, will politicians behave differently than they have behaved in the past?”

    A majority, or large minority of Republicans supported what was essentially Obamacare in the 90s. They didn’t support it when Obama was POTUS. Incentives change. Parties change. Personally, I don’t think most politicians understand health care that well or have deeply held principles on the issue. They are going to change with new leadership or changes in the polls.

    Steve

  • It is falling, but Medicare still polls at 75%-80% popularity.

    Well, yes, free beer is always popular. For most people Medicare provides a great ROI. The typical Medicare beneficiary receives 25% to 300% more in Medicare benefits than he or she paid into the system. My recollection is that whenever M4A is polled along with the taxes necessary to finance it, it polls poorly.

    A majority, or large minority of Republicans supported what was essentially Obamacare in the 90s.

    Could you please support that with evidence? My recollection is that there was a bill that never came up for a vote in the Senate that resembled the ACA but that doesn’t support your claim. IMO Chafee’s bill was just signalling and he was an outlier in the party.

  • steve

    I didn’t look it up so I said a majority or large minority. Sine the GOP pretty much never votes on health care reform, I don’t think you can use the presence or absence of a vote as evidence.

    https://www.politifact.com/punditfact/statements/2013/nov/15/ellen-qualls/aca-gop-health-care-plan-1993/

    Steve

  • As I said, the Chafee plan. It didn’t secure a single Republican (or Democratic) vote in the Senate because it didn’t come up for a vote. It was posturing not a real plan.

  • steve

    But the GOP has never voted on a plan (last year’s vote was really repeal) so how do you use that as a metric? The Chafee bill had at least 20 Republican co-sponsors. Do you see that happening today? I don’t. I can go along with the idea that because the GOP never puts forth health care reform plans AND votes on them, they either don’t care or don’t have a plan, but if we are going to say that they have one, the best we can do is look at the bills they have proposed.

    Steve

Leave a Comment