Matt sensibly notes that Alain Enthoven's list of objections to single payer don't really solve the problem. The market doesn't work and the government doesn't work. So we're screwed? Well, what Enthoven and the Committee for Economic Development are proposing is the development of a "Health Care Federal Reserve" that would be relatively insulated from both market and political pressures. On the left, Tom Daschle is proposing the same thing. A recent poll commissioned by the Mayo Clinic examined this idea (see slide 14), and found that Americans were fairly receptive to the idea. But I don't really buy it. Though a Federal Reserve for health care seems like a promising concept, it's hard to see how an independent, all-powerful board of government-appointed regulators is given substantial control of health care policy. Politically, that sounds suicidal. I asked Enthoven and some others about this yesterday, but they didn't have much of an answer. Which is one of the real problems in health care policy. There's all this fascinating policy thinking, but just about no energy going into the politics behind the ideas. Tom Daschle, who was an actual politician once upon a time, doesn't even mention the political obstacles. I mean, you'd expect these folks at least have a superficially plausible answer like "we'll get the top 15 doctors as ranked by Mayo, and ask the public whether they trust highly-trained doctors or insurers and pharmaceutical companies." But no, there's nothing. Wonks really need to realize that political problems require the same study and seriousness as policy concerns.
