The usually good Michael Kinsley ignored his better angels yesterday and turned in a truly muddled effort attacking Paul Krugman and Robin Well's recent health care manifesto (full disclosure: I'm mentioned in the piece). Kinsley's article is sold as a defense of "modest reform" against "single-payer," which he achieves by ignoring the range of single-payer systems and, like so many others, stereotyping single-payer as Canada. His main complaint is that he fears rationing and, moreover, the inability of rich people to escape it, and thus demands that private money be allowed in purchasing health treatments, and fears that it won't be within the Kurgman-Wells, which is to say single-payer, context. As if to signal the coming misdirection, he even notes that Clinton's plan fell amidst fears that consumers would not be able to buy their own care. What he doesn't mention is that those fears came from Elizabeth McCaughey's viciously inaccurate article No Exit, which was published at the magazine Kinsley used to edit, The New Republic, and which that same magazine formally apologized for last week.
No Exit was so effective because it quite convincingly argued against something that didn't exist. The central claim, as in Kinsley's article, was that ClintonCare would deny individuals the ability to obtain treatment with their own money, leaving "no exit" from the system. This was in flagrant violation to one of the first provisions of Clinton's bill, which stated:
“Nothing in this Act shall be construed as prohibiting the following: (1) An individual from purchasing any health care services.”
Similarly, Krugman and Wells write:
In summary, then, the obvious way to make the US health care system more efficient is to make it more like the systems of other advanced countries, and more like the most efficient parts of our own system. That means a shift from private insurance to public insurance, and greater government involvement in the provision of health care—if not publicly run hospitals and clinics, at least a much larger government role in creating integrated record-keeping and quality control. Such a system would probably allow individuals to purchase additional medical care, as they can in Britain (although not in Canada).
Yet Kinsley picks up the same old tactics to, in violation of their own words, argue that Krugman and Wells support a closed socialism, and thus inescapable rationing, they expressly deny. Moreover, even if they supported such a scheme, I'd be surprised to learn that it would prove constitutional to fully nationalize health care treatment, a move fully unheard of in our economy. As example, in America, we have a single-payer defense system, the military. That doesn't mean, however, that wealthy individuals can't spend their own money seeking luxurious private defense, hence the flowering of military contractors, mercenary organizations, and bodyguard suppliers. The public-run defense is the core, but the rich can seek out boutique defenders if they so wish.
No seriously considered single-payer proposal I know of argues for anything different in American health care and, indeed, amongst the government-run systems of other advanced countries, the ones Krugman and Wells want us to emulate, private care has exactly the second-tier role Kinsley is hoping for. What's confusing, at least to me, is why he felt the need to discredit Krugman and Well's argument by reading in a prohibition that isn't there.
Cross-posted from Tapped
