On Health Care, Some Perspective


Assessing the health care bill that passed yesterday, Harvard economist Greg Mankiw writes, "my judgment is that this health bill adds significantly to our long-term fiscal problems." I agree. He also writes:

Arthur Okun said the big tradeoff in economics is between equality and efficiency. The health reform bill offers more equality (expanded insurance, more redistribution) and less efficiency (higher marginal tax rates). Whether you think this is a good or bad choice to make, it should not be hard to see the other point of view.

I like to think of the big tradeoff as being between community and liberty. From this perspective, the health reform bill offers more community (all Americans get health insurance, regulated by a centralized authority) and less liberty (insurance mandates, higher taxes). Once again, regardless of whether you are more communitarian or libertarian, a reasonable person should be able to understand the opposite vantagepoint.

On this point, believe it or not, I also agree. I think the bill sticks us with a set of fundamentally flawed policy ideas that will have far-reaching consequences for American government and economy, but I do not think it is the end of the world, nor of freedom, nor of America and its founding ideals. As Reason editor Matt Welch wrote this morning, "The sky won't fall. It almost never does." Instead of wholesale collapse, we'll likely see creeping decay. That's a problem, and a serious one. But it's one that, with effort and creativity, can be solved. And that—solving problems—is what should be the primary focus.

Now, often enough, that means shooting down bad ideas. But to a certain extent, the inability or unwillingness to acknowledge and understand the other side's point of view makes the entire problem-solving process more difficult. I wrote earlier today that I disagree with David Frum's assessment that those opposed to ObamaCare should have compromised. But he's probably right that, in the end, the level of rancor from some of the opposition made it somewhat easier for the bill's advocates to push through. Believe me, I sympathize with those who are frustrated. But in sweeping political debates, it's easy for acrimony to reach levels that are not only  counterproductive in the short term, but ultimately do little to help solve the country's long-term problems. I am convinced that, on the whole, the passage of ObamaCare made those problems worse. But, by and large, it's probably better to spend time attempting to convince its supporters that this is true than to spend it than to spend it deriding them for being ignorant or wrong.