You should, of course, read Austin’s thoughts first.
Like Austin, my biggest gripe with this chapter is my frustration with how John portrays his “opposition”. I don’t know who he’s arguing against. He portrays the health care policy debate as one in which it’s him against a whole bunch of Soviet-planning-loving-free-enterprise-hating-capitalism-loathing hippies. That’s just not the way it is.
Readers of this blog know that there are shades of gray. I have discussed the positive aspects of “minute clinics“. Austin has acknowledged times when Medicare Advantage works. I’ve freely admitted that government can stifle innovation and entrepreneurship. It’s not one way or the other. It’s nuanced. Government is good for some things. It’s bad for others.
I could go on and on all day, but that’s a waste. Here’s my lightening round:
1) John makes the all-too-common argument that mammograms can be gotten for $100 and that “a tiny, tiny, tiny portion of the population” can’t afford them. First of all, many, many, many people can’t spare $100. Moreover, that’s not what mammograms cost. Like with birth control, first you need to see a doctor (expensive), then you need a referral, then you need to go get the test. It has to be read. All of that costs money, likely far more than just the “mammogram”.
2) Yeah, I can’t help myself. John is making up the opposition again. He claims that people are upset when private insurance companies deny bone marrow transplants, but not when Arizona Medicaid denied organ transplants. I screamed about those Arizona Medicaid cuts here and here. I even used the words “death panel”.
3) John seems to love entrepreneurs, but thinks they can’t be copied. I don’t think he really believes that. After all, if someone discovers a better way to do something, we replicate that all the time. What he likes is when private people do it, and he hates when government tries to do it. That’s a different distinction.
4) If John hasn’t seen any justification for the rationale for government getting involved in healthcare, then he’s not reading enough. Here’s Austin. He even cites Greg Mankiw.
5) John seems to believe people who disagree with him want change because of process, not outcome. I beg to differ. We’re getting our ass kicked on outcome. Here’s a quote:
What I discovered after many frustrating conversations was that people who like the way healthcare is organized in Canada do not like it because of any particular result it achieves. They like it because they like the process.
Yeah… no. I can’t remember writing a post ever where I argue for a different health care system because I like its philosophy better. Moreover, the outcomes John likes to cite are things like percent of women getting mammograms, women getting cervical cancer screening, people who have had colonoscopies, and men who’ve had prostate screening tests. I can’t think of a better way to illustrate someone who is focused on process more than outcome.
6) Money quote:
If people don’t come to their convictions by means of reason, then reason isn’t going to convince them to change their minds.
That could be a tag line for this blog. Blows me away that John think’s we’re the ones who don’t use reason.