Arnold Kling is a smart, serious guy. A smart, serious guy who says silly, unserious things:
Many people claim that the American health care system wastes money compared with other countries' health care systems. However, what this exercise shows is that waste in the American health care system is not confined to that part of health spending that is privately financed. Resources are not managed any better under Medicare than under private health insurance.
Once and slowly: Medicare operates within America's private health system context, bargaining with private providers at near-market rates. It's new drug plan is entirely operated through private insurers, and Medicare as a centralized market isn't allowed to negotiate for lower prices. Nevertheless, it's held down spending growth slightly better than the private industry and has 1/7th the administrative costs.
Here's the analogy: imagine I said a government-run auto industry would be more efficient. Now imagine that there was one particular group of car dealerships that was run by the government. They still bought from private cars made with private parts by private corporations. They were able to hold down costs only slightly more than private dealerships. Would that be evidence against my view, or would it just prove nationalizing the point of sale doesn't make a damn bit of difference?
Update: Kling writes:
The country of Medicare already is a single-payer system, and yet it is part of the problem of extravagant U.S. health care spending, not part of the solution.
Weird, he knows that's not true, he knows the difference between socialized insurance and socialized medicine...why's he being dishonest? The country of the Veteran's Health Administration is socialized, and it does a helluva lot better a job holding down costs and increasing quality than any of the private or public-private hybrids in the country. Kling's not not comparing apples to oranges here, he's comparing apples to grapes and wondering why the former seems so much more substantial.
