I just fired off an e-mail to Andrew Sullivan in response to his column on healthcare. Full text below the break.
I do see an eerie reprise of his attitude toward Bush. Sullivan was almost worshipful of Bush early on but turned on him when Bush turned out to be an incompetent nincompoop who betrayed every aspect of conservatism. I think he’s once again become entranced by a President who’s a decent guy.
Look, I like Obama. It infuriates me when people describe him as evil or a socialist or, God forbid, not born in this country. I’m opposed to most of his policies and all of the domestic ones. But he’s the opponent, not the enemy. With a Republican Congress — correction, a sane Republican Congress, not one comprised of the current looney-tunes — I think he’d be like Clinton II, only with his pants zipped. I could live with that.
I agree with Sully that sometimes Obama seems like the only adult in Washington. But that doesn’t make him right. Sometimes the childish ignorant lunatics (i.e., the current GOP) are right. And this is about policy, not bedfellows.
I hate to say this, but your column on healthcare demonstrates a panicky foolishness I have not seen since … well, before the Iraq War. There are a number of things I can address, but I’ll go with the fundamental premise: the argument that healthcare costs are crippling our nation is a dubious one and the idea that federal government can address it is even worse.
To address the first part: I find it interesting that you posted (in a negative way) an ad from a pro-life organization that pointed out — quite correctly — that the projections of overpopulation have always been way too high. Panic on overpopulation has proven a perfect example of the Fallacy of the Unbroken Trend — the nonsensical and unscientific belief that exponential or even linear trends can be extrapolated out to infinity and beyond. Its proponents fail to anticipate any adaptation to counter a troublesome trend.
In this case, you note that our healthcare bill can not continue to grow by 8% per year. The lesson of history is that if a trend can not be sustained, it won’t be. Healthcare costs will level off at some point simply because companies will refuse to pay such high prices. You seem to have bought into the delusion that healthcare costs are something imposed on us by fate, special interests or divine intervention — that we are powerless to control costs without the help of our benevolent government. But this simply isn’t true. Health care costs are high because we have demanded more and more of it. We *want* our needless MRIs and our excessive Viagra prescriptions just the way we want our needless pet toys and our excessive iPods. This consumption frenzy is made worse because healthcare costs are mostly paid by a third party.
However, this will not continue indefinitely. When healthcare costs rise to unsustainable levels, companies will not go bankrupt. The will, instead, shift the burden back to the workers with higher co-pays and premium sharing, a process we are already seeing in some industries. This will, in turn, bring the only real force for change — consumer pressure — back into play.
That, of course, assumes that the Democrats don’t, in their zeal to claim credit for the natural and, in hindsight, predictable leveling of healthcare costs, gut this effort. They are already trying to pass a minimum package of benefits (a minimum similar to the one that has caused insurance rates and utilization to skyrocket in many states). They are trying to gut HSAs — which have been the only real vehicle of cost control in the last decade.
Moreover, if cost control is the goal, why are we getting government involved? Can you name a program where the Feds have imposed cost controls effectively? When you were on vacation, did you fail to notice that medical expenses in Massachusetts have exploded since the passage of Romneycare — a program very similar to the one being debate in Congress? How exactly does shifting the burden to government help industry? Without cost controls — which the Democrats are delaying until long after Obama is no longer President — all that does is change the method by which companies bleed money.
For God’s sake, Andrew, who do you think is going to do a better job of controlling costs? Greedy corporate execs with an eye on the bottom line? Consumers with bigger out-of-pocket expenses? Or spineless politicians with an eye on the next election? Almost all the cost control methods you recommend could be done better by the private sector. And in some cases, they *are* being done.
I’ll make a deal with the reformers. Let’s see them get control of the costs in the sector of healthcare they already control. Let’s see real reform and cost control in Medicare and Medicaid. Once they’ve cleaned these disasters up, *then* they can make the case that the Feds should get involved in private insurance. They won’t, of course, because imposing cost controls is unpopular, because they won’t be able to control costs on young people to the benefit of old people (who vote more) and because that would necessitate massive increases in Medicare/Medicaid administrative costs, destroying the lie that these programs are models of efficiency.
The best thing the government could do would be to allow insurance to be sold across state lines — to break up the effective monopolies insurance companies have in individual states. That would allow real competition instead of the bogus “competition” of a subsidized “Fannie Med” trojan horse of a public plan.
(They could also, as long as they’re up, take over the regulation of insurance companies to prevent abuses. My experience of state insurance commissioners are that they are utterly powerless. I don’t see any reason why this couldn’t pass with flying colors.)
I fear that once again you have been lulled into compliance by the siren song of a President you want to believe in. I thought you would have learned to be skeptical when Bush stabbed you in the back.