I wonder how many economists, libertarians, or advocates of health care reform would take the affirmative side of this debate question:
Resolved: the U. S. should have a health care system that covers only some of the American people and 74% of which is subsidized by the government.
I suspect not many. But that’s the status quo as characterized in this post at American Prospect (hat tip: Mark Thoma). If you oppose reform, believe reform is impossible or undesireable, or propose solutions that are political non-starters, that’s exactly the proposition that you’re defending.
the reality is that the current system is not functioning for all and it is not sustainable going forward. Changes to health care will happen, the question is type of changes will occur.
I agree with that completely. Mark supports transition to a single-payer system the virtue of which, as I understand it, is that administrative costs (which in the United States have risen to be the largest single component of healthcare costs) can be brought in line with the administrative costs in other developed countries (which are considerably smaller although rising). In my view we need to consider making a transition to a system in which the demand side incentives and the supply side bottlenecks are both addressed.
Is that a single-payer system? Is a single-payer system a first step in the right direction? It would be more prudent to start considering this now rather than waiting for the flywheel to come off and producing a poorly considered system in the middle of an emergency.