Friday, May 6, 2011

A conservative view on health care reform

I usually read Outside the Beltway to get smart opinions that I am also likely to disagree with. It is one of my ways to avoid being trapped in an “echo chamber” and to get a diversity of views. Today, however, I have to admit that this piece by Steven L. Taylor is very much on point:

Ultimately, all I want is some honesty in the public discourse on these issues, starting with three facts:

a. Yes, Medicare needs reforming,

b. Magical thinking about market forces is not going to work.** I have simply come to the point in thinking about all of this that I believe this assertion to be a dead end.

c. If all other OECD countries do a better job than we do in terms of cost and service, then perhaps we need to be realistic about that fact and look outside for viable models.***

By the way, I don’t pretend to have the answers to this conundrum, but I do think that the debate had to take place within logical parameters that address the actual situation at hand.

[some bridging text deleted to include the relevant footnotes. ed.]

**Understand: there was once a time when I, too, believed that markets in all things was the way to go. Empirical observation, and recognition of the reality around me, has altered my view on this. I still fundamentally believe in markets, but recognize that one size does not fit all.

***This is something else I have changed my view on over time. Indeed, I am not alone. See, for example, the following post from Reason‘s editor-in-chief, Matt Welch: Why I Prefer French Health Care (and yes, the libertarian magazine, Reason).

Now I am sympathetic to the argument that true free market health care hasn't been tried anytime recently. It has some issues that would have to be overcome. Externalities due to antibiotic overuse, for example, are not trivial to handle outside of regulation. Nor is it clear precisely how one would handle fraud in a way that would not be a legal nightmare.

But there are health care models that are both more and less functional than the current United States model. Why would we not look more closely at, for example, the German model before assuming that a massive social experiment makes sense?

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