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.