Friday, September 26, 2008

Economy be Damned

Who's worried about the Wall Street Meltdown? Certainly not Democratic Delegate Heather Mizeur:

No matter who wins the presidential race in November, a national debate on health care is sure to start in 2009, Del. Heather Mizeur said Tuesday.

"It will be a different kind of debate depending on who wins. It seems like every 10 to 15 years we're ready to take this national health care debate on again," said Mizeur (D-Dist. 20) of Takoma Park.

Can you imagine, in this kind of fiscal environment, liberals trying to start a showdown on health care at the state and local level? We already have a situation where government has expanded far, FAR beyond its means. We already have a situation where government cannot afford the spending that has been undertaken at all levels of government. Are Democrats really ready to launch a debate in which they will propose the largest expansion of government social programs in American history knowing that they would need to raise taxes on the middle and working classes to pay for it?

I agree that we need to discuss reforming health care at the national level. But discussion the rapid expansion of government services at a time in which we absolutely cannot afford it is silly and naive. If the Democrats at the state and federal levels really go ahead with this, they will be saying "economy be damned, full speed ahead."



Gunpowder Chronicler said...

Yes, let's have a debate on health care.

Let's talk about how the abuse of Shock Trauma raises the cost of health insurance for all Marylanders.

Let's talk about Maryland's obscene fixation on "the golden hour", even though that standard has fallen from grace.

Let's talk about the $357 million ambulatory tower that UMMS just cancelled -- long after construction had started and concrete was pouring. What happened to the state dollars invested in that adventure?

Let's talk about how the takeover of Maryland General and Easton Memorial by UMMS has not lowered costs OR improved patient care or patient outcomes.

I am ready for that debate.

My Shoes said...

Let's talk about one of your loved ones getting maimed and horrifically traumatized as you watch it get thrown into an ambulance that struggles through annapolis traffic to receive 2nd rate healthcare.

What are your thoughts ?

Daniel said...

And let's talk about the reduction in helicopter usage to speed the injured to shock trauma.

Let's hope it isn't anyone you know that doesn't need this kind of speed.

For that matter, let's hope the person in Balto City complaining about the copter noise doesn't win his case.

bruce.godfrey said...

If a national program of health insurance is actually more efficient than the current system - unlikely under traditional free market models but perhaps quite possible in reality - then its institution is a positive benefit to the entire economy.

Right now, the very poor get care either from Medicaid and programs like (S)CHIP, from ERs in public hospitals and locally funded clinics. The very old get it from Medicare and a patchwork of health coverage. The very sick get it from where the very poor get it (often overlap) and from disease-specific programs such as HIV treatment programs in many cities including DC. In addition, the federal government already subsidizes federal employees and their families, the military and their families and of veterans through a pretty well-run VA (an example of reasonably efficient government-administered health care). Illegal immigrants and their families get coverage from ERs with minimal paperwork. We are already hard-core on the hook.

I wonder whether between the costs of duplicative public administration, wheeling and dealing costs from advertising by private carriers, employer costs of changing carriers often every year, a money-cost-of-time economic incentive to get care at the cheapest and quickest place (not the horribly expensive and chaotics ERs when you have access to a more realistic alternative) and butt-covering and accounting paperwork by all involved, enough cost savings might be realized to have a federal guarantee of coverage come very close to paying for itself in the medium term.

If it DOES more pay for itself, we NEED to institute it to help us cope with our multiple other economic problems; health care is 15% of the economy and a major increase in efficiency system wide would lift all boats. It's counterintuitive and it violates free market orthodoxy, but so does the Interstate Highway System and nobody calls us "socialist" for that one.

If France and Canada were the only models of national health care, I could understand skepticism. I don't want to adopt Canada's nasty system that jails doctors for going outside the system on covered services; France's is supposed to be better than Canada's but I wouldn't want it either. But countries like Australia and New Zealand and Ireland - countries with significant free market elements in their societies and living standards and tax levels approximately the same as ours or, in Ireland's case, lower levels - maintain national health care for all citizens. The Heritage Foundation puts those three countries in the same order of magnitude as the U.S. in terms of economic freedom, and pretty much nobody calls Heritage a bunch of pinkos.

Paul said...

Well said Bruce. Any efficient program that ensures quality care immune from current cost-profit pitfalls stradles a tight line. However, statisical analysis needs to be done immediately to see if this program can indeed pay for itself, a considerable feat for a government in turmoil. We must examine each option thoroughly.