There Is No Such Thing As a Free Health Care. But There Are Lots of Things Called Free-er Health Care That Get Really, Really Expensive In Ways That Range Far Beyond Dollars and Cents.


The doctor is in…sane

Get ready for the Summer of Glove, as in rubber-examination gloves used for digital exams. This time the patient is the entire U.S. economy, which we're being told suffers from bloating and sluggishness due to way too much spending on health care.

Legislation to revamp the health-care system likely would cut the rate of annual growth in costs by 1.5 percentage points, increasing the gross domestic product by more than 2 percent in 2020 above what it would be if no changes were made, according to projections by President Barack Obama's Council of Economic Advisers.

"Health care reform is incredibly important not just for the American people but for the American economy," Christina Romer, who chairs the council, said in a briefing for reporters on the CEA report released this morning.

Those are the types of bold, long-term predictions that hold as much water as an 88-year-old man on a full-liquid diet. I mean, really, if you're going to make predictions that are completely pulled out of your ass, why not follow what Treasury did with the TARP bailout and just choose a "really big number" picked out of thin air?

More to the point, the Wile E. Coyote Super Geniuses in D.C. have been working overtime since their junior-high theses on proposals to finally fix health care (despite it not being totally clear what the term even means, or how it means very different things to very similar people).

They have seen the past and it didn't work. But that doesn't mean it can't not work this time:

Democrats, who control both the House and Senate, are considering proposals that would require employers to cover all full-time workers or pay a penalty to the government; create a "health exchange" to allow consumers to buy insurance at lower, group rates; set up a new government-run plan to cover some of the uninsured; and levy new taxes to pay for universal coverage.

Employer mandates. Insurance pools. Government programs. New taxes. Hope and change, and even without Tom Daschle in the cabinet! I don't know they do it, but goddamn, it's beautiful.

Exactly how any of the above differs from what we're already doing escapes me. Our health care system is the ugly accretion of decades of stupid government policies (starting with the decision not to tax employer-based health care costs as compensation, thus pushing the idea of tying coverage to the workplace) that have gotten gnarlier and more twisted with each additional, incremental add-on.

So, if you're actually legislatin' in the 21st century on the promise of hope and change, why not actually start thinking about doing some things that are genuinely different and have at least a snowball's chance in hell of working?

Start with injecting actual market forces into health care by disrupting professional cartels that raise the cost of buying any prescription drug by $100 or whatever you get charged for a perfunctory doctor's visit (and by the way, start questioning the prescription drug regime too)?

Inject some actual price signals into the system by getting rid of the tax-code hocus-pocus that creates third-party payer systems and gets employers, most of whom can't turn a goddamn dollar at their chosen field of expertise, into the business of providing health care?

Take an example from fields such as dentistry and eyecare, where fewer services are covered by insurance and hence more open to the sorts of competition and discovery process that routinely drives prices down and the level of services up in every area of exchange from airline tickets to hamburgers to high-tech computer gear. And recognize that health insurance is not the same as health; indeed, it's not quite clear just exactly how the two are linked.

And also take a deep breath and recognize that spending more money on health care is not necessarily a bad thing, if it's the free choice of people (which currently it isn't). Like eating more prepared meals, it can be a glorious sign of increasing wealth.

But most of all, stop acting like characters from Tennessee Williams or William Faulkner. Learn from the past already, don't just mindlessly repeat it.