Exploring The Polarized Health Care Debate

In “When Planners Decide Life”, Michael Gerson calmly outlines the real issues that politicians have avoided discussing in the health care debate. These issues need to be resolved if  health care reform is hoped to be anything other than divisive and polarizing.

The inevitability of health care rationing in any plan that makes free or extremely low cost health insurance coverage universally available has to be addressed honestly. So far, while vilifying insurance companies, proponents of the administration’s favored solutions are pretending that government bureaucrats rooting out waste will create vast new resources enabling essentially unlimited coverage for all.

Virtually everyone  agrees escalating health care costs  need to be dealt with and we do need to address the challenge of access to care for the uninsured. But there is good reason most people are skeptical of government taking over a health care system that is generally providing good service for the majority of Americans.

Supposition of  well planned super efficient government management of vast swaths of the economy is simply not credible to anyone who has ever watched the costs escalate on a highway project like Boston’s Big Dig or who watched the government make two major revisions in a matter of weeks to the  recent “Cash for Clunkers” fiasco, throwing three times as much money as planned into the program at the same time  they scaled back the time schedule for eligibility by more than half. Government economic planning just doesn’t have a credible track record.

Giving away vast amounts of free money, whether for cars or for health care is going to balloon out of control. Anyone suggesting such generous largess can be done without rationing, especially with government deficits already in the trillions, is either very cynical or very naive.

Failing to address the inevitability of rationing honestly, especially as regards to emotional end of life issues, just builds on the natural and rational skepticism of those opposed to government management of the economy.

Polarizing the political debate makes workable solutions to the fundamental challenges of health care harder to reach, eroding  hope for respectful and productive policy dialog.



Filed under Fundamental Perspectives, Health Care, Politics

4 responses to “Exploring The Polarized Health Care Debate

  1. Michael Barrow

    I like George Lakoff’s take on why this is being a disaster for the Obama administration (and what to do about it):


  2. fredunger

    I guess we’ll have to disagree on this one Michael. I found the tone and language in the article you linked to be quite divisive. It seems to me that everyone is talking past each other rather than with each other.

    Fundamentally I guess it comes down to whether you believe the government should manage the economy. My sense is their track record on economic management of everything is remarkably bad, so I have a hard time imagining a government takeover of the health care system as good news. The rest is all details.

  3. Michael Barrow

    How is a private, for-profit industry that extracts as profit 25 to 30% of every dollar getting paid toward health care going to be more efficient and fair than having the government running it? If I follow your logic, then why don’t you lobby for private, for-profit fire fighting service or police service or libraries or road plowing? The government does all of those things for us, they have a monopoly, and they are probably horribly inefficient at all of them. There’s money to be made in the name of efficiency!

    Here’s a different, lighter take on the whole issue:

  4. fredunger


    Up until quite recently, the majority of fire fighting in the nation was done by volunteers – still is in most rural communities and even some fairly good size towns. And most plowing is done by private contractors. Policing and law enforcement in my mind is a special case that should remain the public purview.

    I really don’t think there is a lot of value in a stratospheric level general debate about government intervention vs private enterprise. I tried to explore the somewhat irreconcileable world views between free market advocates and interventionists at https://emergingconsensus.wordpress.com/2009/04/08/free-markets-vs-intervention/

    The real issues on health care are really well explored by David Goldhill here: http://www.theatlantic.com/doc/200909/health-care. Bottom line, it doesn’t matter whether it is government or private health care. If reform doesn’t change the fact that there is anyone besides the consumer paying for routine non-catastrophic health care, the health care will remain a wildly expensive system of questionable quality. It isn’t a rational market when someone other than the consumer is picking up the tab.

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