HARDER, BETTER, FASTER, STRONGER. Good column by Daniel Gross making the point that, contrary to popular belief, America does have a sort of national health care system. It's just not organized in a way that makes any sense. If you tally up the amount spent on deductibility for employer-based care ($208 billion), Medicare ($378 billion), Medicaid ($180 billion), not to mention military health care, coverage for public employees, and various sundry other programs and subsidies, you have the federal government picking up 2/3rds of the total tab for health care in this country. It just does so in an inchoate, nonsensical fashion. Some politicians, including former governor John Kitzhaber, argue for simply totaling up the money we already spend, then funneling it all into some sort of new, coherent program that could do much more for much less. After that, we could talk about new funds. Always seemed sensible to me, but the political life expectancy of someone suggesting an end to employer deductibility can be measured in moments. That said, if anyone has an argument for why we wouldn't be better off using this cash to fund an intelligently-designed, smartly-targeted program rather than the mish-mash of disconnected aims and historical giveaways we're currently pursuing, I'd like to hear it. --Ezra Klein
