David Brooks uses his column today to complain that Congress is not prepared to impose the cost control measures that will be needed to make health care in the United States affordable. He is right to raise the issue, but he does not present the options accurately. The basic story of the U.S. health care system is that prices are inflated by enormous rents everywhere. Our doctors get paid twice as much as doctors in Canada, Germany, and elsewhere. (I know, they will all work as shoe salespeople and custodians, if we cut their pay.) We pay twice as much for prescription drugs as everyone else. And we throw 15 percent of our health care expenditures in the garbage, paying insurance companies to deny people care. There are two ways to contain costs. The most obvious is to cut the rents. Use international competition to bring doctors' salaries down to earth. Get rid of government patent monopolies and develop a more efficient mechanism to finance the development of prescription drugs and medical equipment. And, allow people to buy into an efficient public Medicare-type insurance plan. But, Brooks backs down from such substantive changes. These reforms would hurt powerful interest groups. Instead, he wants to see Congress cut costs through the alternative route of giving people less health care. Brooks is disappointed with Congress. Readers should be disappointed with Brooks.
--Dean Baker
