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, www.gooznews.com, 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 www.gooznews.com, directs the Integrity in Science project at the Center for Science in the Public Interest.