James Bacon writes at The Bull Elephant that he doesn’t think Virginians should have health care if that means taxing the wealthy and regulating providers.
“The healthcare system is so immensely complicated, with so many moving parts, so many feedback loops, and so many hairy ethical questions of life, death, and well being, that it is exceedingly difficult for politicians or the public to understand.”
These “hairy questions of life, death, and well being” are what makes allocating health care as a commodity through market forces so immoral – and impossible, Mr. Bacon.
“Here’s the problem with subsidies: They’re never enough. Never ever. The political class always wants more. There’s always someone who falls between the cracks. There’s always some unmet need. There’s always a new, higher standard of care to be insisted upon. Unlike taxpayer’s pocketbooks, the demands are endless.”
Too long, don’t read James Bacon: We cannot improve health care access through regulation because it’s just too complicated, and subsidies are never enough. No program will ever meet every need, so we should do nothing at all. And by the way, some taxpayer’s pocketbooks are, in many practical ways, more or less endless.
Bacon thinks “price transparency, competition, and innovation with the goal of enhancing productivity and improving outcomes” (that is, markets), will solve the problem. And I guess that if you’re a conservative who thinks access to life-saving treatment should depend on ability to pay instead of a shared moral obligation to our fellow man (as expressed, for example, in the “red letter” Bible verses) you might be right. Only, of course, if you’re OK with the “some people will die because they cannot afford to buy insulin” part.
At the end of the day, no amount of price transparency, competition, innovation, or enhanced productivity will change this one fundamental fact: every consumer’s demand for health care will eventually become so inelastic that none of these things will matter in any way. Everyone will pay any price demanded because it keeps them alive.
Bacon thinks this is the fix because his only tool is a market, so he believes every problem is a price transparency and competition failure. In fact, we have a better chance to make our health care system more efficient by honoring our commitment to each other, accepting health care access as the human right it is, and working together to ration according to need rather than resources. In the end we all benefit because in the end we’ll all have the same need: life-saving medical care we won’t be able to pay for without help.
He has apparently not heard of Medicare for All – the best expression of this shared commitment to the common good we have today. I’ve read this legislation from cover to cover. Everyone pays in, and they do so the minute they start working. And everyone takes out, and the do so the minute they get sick. This system also costs less – and the people who oppose it do so because they generally have something to lose because it does.
Medicaid expansion has improved the lives of almost half a million Virginians, but that alone cannot save everyone. McAuliffe’s reinsurance plan won’t, and neither will Medicare for All.
The one idea Bacon doesn’t mention can get us closer. It’s time.