If You Read Only One Article on Health Care This Year, Read This One (And The One It Links Back To) By Virginia Postrel


Former Reason Editor in Chief Virginia Postrel wrote the smartest, most insightful critiques of centralized health care plans during the 1990s.

Now at The Atlantic, she has written two excellent related pieces about looming changes to health insurance and treatment. Her work is rich in analysis and detail and stresses basic points that are typically overlooked. There is no simple fix, she argues. Most people want free-to-them treatment, regardless of the larger costs in terms of pharmaceutical, technological, and provider innovation. Most politicians want to clamp down on costs and jack up government oversight. Free-market folks often simplify the issues at stake. Centralizing decisions in virtually any business or service sector leads to predictably bad results over time.

Here's a snippet, but I urge you to read the whole thing.

Health care isn't a single good, nor, like food, is it easily defined in terms of a minimum to sustain life. Studying other countries' supposedly universal systems only demonstrates how fraught the concept of "health care" is: one bundle of services in British Columbia and a less-generous one in Nova Scotia, one in England and another in Scotland, one in New Zealand before the election and another afterwards. Arguably the U.S. already has universal care, in the sense that everyone can get some care-if only from an emergency room-for some things, and that citizens (a critical word in this context) without money are covered by Medicaid. The real issue is how you define "health care." What gets included is a matter not only of medicine and economics but of culture and politics.

Start the whole thing here.

Postrel's Reason archive here.

As with education, we are slowly shuffling toward the sort of individualized service that we take for granted at the neighborhood coffeehouse. It is way to slow a process and (again like education) entire generations will lose out because of the snail's pace of change. As the public sector starts to hog the roast beef at the cold-cut table (often in conjunction with private industry), it is worth keeping in mind that the parts of American life that are most annoying (K-12 education! health care!) are also the ones in which creative destruction is most hemmed in.