Thursday, February 11, 2010

Think of the Thirty Million, Part II

Except that, it's not 30 million who will get needed health care--it's 30 million who will be required to buy insurance, much of which will probably not be useful. A lot of those will be younger people who will never use the insurance, and some will undoubtedly be bankrupted by the mandates. Sounds like an electoral loser to me.

That's the populist argument. The policy argument goes like this: the cost controls in the Senate plan are hopelessly inadequate. There is little regulation and no public option (itself a form of regulation.) Which means that US health care costs, already high and rising, will continue to rise and, at the end, when the system costs too much to sustain, the main difference between the Senate plan and doing nothing will be that a lot more money has been funneled to the health insurance branch of the financial services industry, some more has been funneled to Big Pharma, and perhaps a few more people have gotten care: the exponential rise in costs will swamp the additional money fed into the system by the mandates.

Perhaps, perhaps. I would like to hope for something better. I don't think the rising costs are quite as terrible as most economists: eventually, people will decide how much care to spend for. I have my doubts that the continued expansion in end-of-life care costs will continue. (This could all be upended by a real life extension technology, but that seems unlikely.) But unless something more effective at cost control than the Senate plan is passed, the US health system will continue to be the least efficient among developed nations by a factor of at least two, and that will be a continuing drag on the economy at a time in history when we can ill-afford it.

No comments: