Merrill Goozner: Changing the Topic


Listening to the gay marriage debate on NPR amid the ongoing revelations about the mass murder at Haditha, I feel as if I’m listening to the late Gilda Radner on Saturday Night Live ranting about something she misheard. When corrected, she would blithely reply, “never mind.”
Since changing the subject seems to be the Republican strategy here in the nation’s capital, I will give it a try myself for readers of The Washington Note (though not my own blog,, where I’ll be cross-posting these comments). Let’s talk about health care. Specifically, I just came back from a forum at the Center for American Progress where an all-star cast of Times columnist Paul Krugman, CAP senior fellow Gene Sperling, Times reporter Louis Uchitelle and Economic Policy Institute economist Jared Bernstein weighed in on the growing inequality in the U.S. economy. Other than Uchitelle, who didn’t address the topic, all seemed to agree that health care is going to be one of the if not the major domestic issue of this election and for years to come.
Krugman and Bernstein held up the left flank admirably, calling for a single-payer system to replace our truncated insurance-based system that provides worse health outcomes at twice the price. Not a very good advertisement for free-market approaches to providing this social good. “We have a society now in which people face a lot of gratuitous risk,” Krugman said. “The aggregate cost of health care is well known. Why make individuals absorb that risk?”
Sperling, who was a key figure in the President Clinton’s 1993-94 health care fiasco, seems to have retained that administration’s fervent embrace of small bore reforms that don’t really solve really big problems. While he admitted business’s growing demand to get out of its current health care obligations could well be the trigger for another massive reform effort, the best he could come up with was a program for “health care between jobs” for those who get downsized, outsourced, laid off and otherwise cast aside by our ever changing and globalizing economy.
I was disappointed by all the presentations on this vital topic. I’m a big backer of “single-payer,” “Medicare for all,” or whatever you want to call nationalized health care. After all, why shouldn’t we join the rest of the industrialized world? But it’s not the ultimate answer to our health care problems. It will deal with the uninsured. It will eliminate the 15 to 20 percent of health care costs absorbed by duplicative administrative waste. But that’s a one-time saving. Then we’re right back to health care spending rising at two to three times the rate of inflation.
Until we deal with why Americans are sicker than our counterparts in Europe and eliminate the waste in much of the new technology that is driving health care costs skyward, we’ll never get our health care costs under control. I’ll address both of those issues more in depth in the coming days.
Merrill Goozner, author of “The $800 Million Pill” and blogger at, directs the Integrity in Science project at the Center for Science in the Public Interest.


10 comments on “Merrill Goozner: Changing the Topic

  1. anonymous says:

    American workers ARE units.There is a steady erosion of decency towards, and a constant increase of hostility and contempt towards those pesky Americans with spines by greedy fascist sociopathic employers. And instead of solving illegal immigration by going after employers, the issue is kept in state of chaos, to keep anything from being resolved, immigrating laborors illegal and therefore without rights or protections.Rights and protections would level the playing field with American workers, and wages might have to creep up a bit, and the oligarchs cant have that. Becuase if there were to be an immigration bill passed, that was equitable to all, it would erode the edge on keeping labor illegal and cheap. The issue of illegal immigration is SIMPLE to solve, just JAIL anyone who employs an illegal and levy heavy fines as well. If this were initiated, the “problem” of illegal immigration would dissapear virtually overnight. Politicians act like there is no solution and offer capitulation instead of solutions. And that makes perfect sense, because solutions, as simple as they are, would require those politicians to cross the interests of the corporations they represent. That is the ONLY problem we have in the USA. The governent no longer represents anything other than monied interests. That goes for BOTH the democrats and republicans. There will be no change until we restore government for the people. We have to take back the political parties, run our own candidates, stop accepting whatever “frontrunners” are foisted on us, and start to pay close attention and question every action of those who supposedly represent us. AND MAKE THEM KNOW WE ARE WATCHING THEM, and will hold them accountable for their actions in the voting booth.


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  5. Den Valdron says:

    For the record, the Health Care system up here in Canada works pretty damned good.


  6. Carroll says:

    BTW….suggestions have been made other than the single payer system….going back to the days of NON PROFITS like the original Blue Cross would be one way… there is a choice between goverment controlled health care and Wall Street Golden Parachute CEO controlled health care.


  7. Carroll says:

    As to why Americans are sicker than our European cousins…I suggest you compare the working hours and weeks in the average European country to the US for one thing…and the fact that their health care system gives them earlier access to health professionals then our system in which people avoid the cost of doctors until they have no choice and the uninsured wait until their condition is so bad they need emergency room care.
    Add to that “lifestyle”.. which leisure time is a important fact in…. no doubt about the fact that American workers who do the actual producing of goods in this country go flat out 24/7 with their job and family duties and that causes them to have less energy and put less thought and time toward their own health.
    In the US workers are “units” not humans and are replacable and disposable. But don’t worry we just imported a few dozen million illegals to take up the slack when the current crop of American serfs expire.


  8. eCAHNomics says:

    (I’m not a conservative but I have a healthy distrust of government.) There is no good alternative to either the status quo or the single payer system. Which is why you never see any good alternatives. (Same reason you don’t see any good alternatives for Iraq–there aren’t any.) The reason I will always harp on the defects of the single-payer system is that liberals keep harping in favor of it without any hard-headed analysis of what might be wrong with it. W’s handling of Katrina is the single best example of what’s wrong with a single-payer medical* system.
    So here’s the economics of medicine–it’s the mafia of the intelligentsia. The knowledge gap between buyer and seller creates pricing power for the seller. Add to that market imperfection the fact that the customer is vulnerable, giving the seller even more pricing power. Third party payment, dubbed by those more clever than I, is the veterinary model of medicine–the payer determines not only how much it will pay for the pet’s medical care, buyt also what kind of medical care the pet will get. That’s why the U.S. medical system is out of control. All the usual suspects are merely symptoms of the generic economic organization of the industry.
    The last thing in the world you would want is a government provided box of housing, and housing is just as expensive & complicated as medical care. Why would you want incompetents like W and Frist determining what kind of medical care you get? Did Terri Schaivo not put tremors in your soul?
    National medical care has worked better than the U.S. system in several countries, especially in controlling costs, which accounts for its attraction for liberals. But I’d caution: Be careful what you wish for, and think that it wouldn’t work well in the U.S. because the politics and pressures are different here.
    *One minor indication of the power of the mafia of the intelligentsia is that they’ve got all you folks calling it “health” care instead of medical care. Medicine is probably the smallest component of health, with genes and lifestyle swamping anything that medicine contributes to health. (Some exceptions, like old-style public health measures & vaccines.)


  9. gmax says:

    It never ceases to amaze me that conservatives are so eager to bash the single-payer system without offering practical alternatives to the status quo. The lack of any positive effort to improve the health care system by the GOP Congress and Administration in the last five years is pathetic. Ooo, but then there’s the Medicare Prescription Drug program…


  10. eCAHNomics says:

    It never ceases to amaze me that liberals are so eager to entrust their medical care to W, which is what a single-payer system would do.


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