By Dylan Matthews
Hey all. First off, thanks to Ezra for giving me the chance to blog today. It's a great break from freshman orientation which, though fun, is sadly devoid of policy wonkery.
On that note, Robert Samuelson plays his role as the Washington Post's resident entitlement program concern troll particularly well today. There's plenty of objectionable material in the column, from its assertion that being uninsured doesn't really lead to worse health outcomes (not true) and Samuelson's claim that the American health system doesn't "shortchange" the poor (totally false). The most strikingly wrong element of the piece, though, is the false dichotomy it presents between universality and controlling costs:
There is a basic dilemma that most Americans refuse to acknowledge. What we all want for ourselves and our families -- access to unlimited care paid for by someone else -- may be ruinous for us as a society. The crying need now is not to insure all the uninsured. This would be expensive (an additional $123 billion a year, estimates the Kaiser study) and would provide modest health gains at best.I don't think there's a single advocate of universal coverage who denies the cost growth problem that Samuelson harps on. Ezra's written quite a lot about it. Ted Kennedy (the subject of Samuelson's attack) hasn't exactly been silent on the issue. The argument isn't that universal insurance is a more important priority than cost containment. It's that universal insurance is the most effective way to contain costs. Jonathan Cohn explained it better than I can in the May issue of TAP:
[T]rue Medicare reform would go far beyond Medicare. It would fix the whole health-care system by creating incentives for all providers of medical care to observe cost-effective medical practices. It would create new scientific institutions (or redirect existing ones) to establish what those best practices are. It would create some sort of electronic medical record system, to cut down on errors and improve coordination of care -- both of which ought to help reduce costs (not to mention make people healthier). Above all, it would also make sure all patients had a way to pay their bills, so that doctors and hospitals now performing charity care won't have to steal from other funding sources to do it.Under socialized medicine, the whole thing reads you.In other words, the best way to keep Medicare affordable would be to create a well-functioning universal system.
