Ramesh Ponnuru makes a compelling case that “universal” health insurance coverage should not be the primary goal of health-care reform. The case is simple: the cost shifting which politicians point to as a reason for mandating coverage for everyone is relatively small. It can be addressed in less destructive ways and is a less critical problem than other issues (e.g. soaring costs and lack of portability).
But there is another reason to avoid “universal” plans: so far they haven’t worked. In Massachusetts, the best effort to use “market” reforms to attain universal coverage has resulted in less than universal coverage and rising costs. California abandoned its proposal and Hawaii pulled the plug on its universal coverage system.
Once you force coverage for everyone the cost skyrockets — unless of course you start limiting care, cutting doctors’ fees, and controlling what sort of treatment you will pay for. That has been the experience in the western countries that have gone down this road. The alternative — to try to stimulate competition among insurance carriers, have individuals purchase and control their own insurance and provide subsidies for the hard-to-insure cases – seems infinitely more attractive than duplicating the problems of other countries.
But the Massachusetts plan has been edifying, and perhaps the argument is better made by allowing fifty separate state experiments to bloom rather than creating a one-size fits all federal system. Maybe one of those fifty, or more than one, will hit on a formula for expanding coverage, improving care and reducing cost. The odds are certainly better than they would be under a single untested federal plan. So if “something must be done,” a system of block grants and a period of experimentation might be in order.
That would be less grandiose than a single federal scheme. But it might do less damage and produce some real world experience on which we can draw to create a workable national system.
Number One’s failure to hurl Timmy G off the bus is puzzling. Timmy has a wimpy public persona; he’s got 17 or so top posts empty (hmm, perhaps that’s part of the problem — ever hear of a business with 17 top posts, filled or unfilled); and he doesn’t even have the gumption just to give all the money away.
Number One needs a strong Treasury Secretary, but he’s afraid of one who might go off the reservation — talking about tax cuts for example, or the dangers of trade barriers. And Number One already has more than he can handle with Larry Sumners’s ego.
So long as the Dow goes “up and down” — to use Number One’s technical analysis — I suspect that Timmy will be able to hold onto the bus’s fender.
According to CNN:
” Biden indicated that a number of local projects that would ordinarily be considered a legal and appropriate use of federal dollars would be barred under the stimulus plan. For example, he said, states would not be allowed to use any stimulus money to build swimming pools.
The vice president emphasized that the stimulus money could be used for only three goals: to put money directly into the pockets of individual taxpayers, to create jobs in the near term, and to make investments in “jobs of the future,” such as solar power or the development of a so-called “smart grid” for electricity.
Fifteen billion dollars in stimulus funds had already been allocated for Medicare assistance, noted Rob Nabors, deputy director of the Office of Management and Budget. Thirty-six billion had been allocated for transportation funds and $7 billion had been spent to assist workers who had lost their jobs.
Biden warned, however, that federal assistance to the states would be cut back if the stimulus dollars are not spent in the most transparent and cost-effective manner.
The administration is “not kidding” about the need for accountability and transparency, he said. “If we don’t get this right, folks, this is the end of the opportunity to convince Congress that anything should go to the states.”
“Six months from now, if the verdict on this effort is that we’ve wasted the money, we built things that were unnecessary, or we’ve done things that are legal but make no sense, then, folks, don’t look for any help from the federal government for a long while,” he added.”
We see the implication of Biden’s statement: “If the states don’t spend the money the way we want them to spend it, we’re the ones that are going to be doing the spending from now on.” The concept of statehood takes another hit, after having a few beers in the roadhouse of national politics, the feds and the state go out in the parking lot to settle their differences and the state wakes up with a bloody nose and his pockets turned inside out.
“Big Labor continues to fight against itself. Must have picked up the GOP playbook by mistake.”
I nearly spit my coffee with that one.
You have to wonder if the problem with Geithner isn’t that he needs to shelter himself and Bernake and Paulson from potential criminal liability for deeds of the past year. I don’t really have anything on this but is there a better explanation for the inability to attack these problems in a straightforward manner. (Well there are two. (1) The solutions will be very unpleasant for the owners of the FED and (2) There is no solution from a statist / corporatist perspective.)
the ny post is zuckermans paper isn’t it?
he should rerun some of his we need to invade iraq editorials just for laughs
5: Yeah, leastone, yeah, the NYP is Mortie’s paper, and used to be Gloria’s too. Now dip your pacifier in the laudanum, and get back under the restraints.
“‘The president was basically [...] announcing a continuation of the policy in Iraq and Afghanistan.”
This may be good for some laughs; but mostly, it is a cause for celebration.
Give the credit where credit is due – in this case, the Obama team.
They couldn’t keep faith both with their country and with
their promises to the defeatist part of their base -
and wrt Iraq and Afghanistan, they chose the former.
Re Geithner: If he gets fired now, who’s going to answer the phone? There’s no one else there.
I could be a pundit or “editor” too if i bought a newspaper.
9 – You could have. There was (and still is) a fire sale on newspapers all over the country. You just missed the Rocky Mountain News, but it looks like the Seattle Post-Intelligencer is on it’s last legs.
Yeah buy one, newspaper is consider junk stock anyway.
good riddance to all of them