Folks konw I think McMegan is an interesting writer. Some of you even hold it against me. But just this once, you can't stop e-mailing to tell me she wrote a really, really long post on health care. I know! I read it! It's very bad!
It relies on unproven and incorrect premises ("Most advocates of single payer, I think, care most about this justice claim. They may also think that they can make the system more efficient, but if one could somehow prove scientifically that a private system would be cheaper and better, they would still favor a public system as long as a substantial population remained uninsured); brackets the argument about efficiency then pretends it doesn't figure into reformer's claims; radically overstates individual culpability for illnesses; elides the fact that living a healthier life just means you die from something expensive later; mistakes an intergenerational compact (wherein each generation pays for the next, rather than making a one-time transfer) for charity; and appears to miss the fact that Medicare already exists, and so single-payer would not mean more resources would be transferred to the old, thus obviating the central point. And that's just a partial list!
But this is the type of bad I can get behind. McMegan's post is one I disagree with, but do not fear. Indeed, if some eager speechwriter plugged it into Mitt Romney's next address ("My fellow Americans, I think it's time we abolished Medicare, because the old don't deserve our help. And we should also stop caring for the sick, because that colon cancer is your own damn fault Mr. I-Don't-Eat-My-Fiber.") I think we'd have found the straightest line between here and national health care.
Lately, though, I've been trying to think more systematically about which health care arguments are dangerous to reform, rather than just annoying to reformers. Here's what I've got so far:
- The government can't do it. It'll be like the DMV. It's "socialized medicine." Do you love waiting times? etc.
- It'll be too expensive.
- Incrementalism-as-obstruction. i.e, "We should have a more "American" system based on tax credits and deductions!" These proposals don't have the downsides of real reform, but they don't fix anything, either. However, they do make it seem like the politician "has a plan." See Giuliani, Rudy.
- National reform will fail, as it always has, and the cause will be dealt an enormous blow, just like in 1994. Better to be incremental and just cover kids or something.
- It'll reduce pharmaceutical innovation.
Any more?
