• The best policy and political analysis of the botched ACA rollout

    Go read Mike Konczal. Just do it.

    His chart is worth keeping in mind, so I’ve copied it below. But I’m not going to add commentary because his is too good.



    • I think Konczal errs in formulating the choice as A or B. Why not improvements to A? I suppose his (and Douthat’s) answer is that one of the players (Republicans) refuse to even consider improvements, believing that failure is the (inevitable) goal. Douthat fears that failure of A will result in B, something that wouldn’t disappoint Knoczal. Indeed, one might get the impression that Republicans and progressives have finally found common ground: failure of A. Down is up.

    • I have to ask: who is sabotaging A?

      • I would argue it is an inherently faulty mechanism for the delivery of healthcare …

        The market may be good for deciding the ultimate price and delivery of potato chips – but not for healthcare …

    • A number of the conservative ideas for market-based solutions have such heavy gov’t management of the “market” that you have to wonder if it is doing more than enabling commercial gain from a captive audience. Privatizing social security wasn’t planning to allow people to gamble on currency futures, it would have looked a lot like the college savings plans — a limited bunch of highly regulated safe choices.

      In the end, it’s a market veneer on an inefficient system.

    • He might be right that business and government working together against the consumer are worse than Government business and not for profits without Government might still be the better than that.

      Price breast implant surgery verses a similar surgery covered by insurance.

      Also Government schooling is category A and it seems to have a similar run away growth in spending that plagues medical care.

      Government provision of health insurance would have been easier to provide when health care was under 5% of GDP but now health care is 18% of GDP. Half of that is already government spending but still raising taxes another 9% of GDP might be difficult. One might argue that though you will raise people’s tax you will also reduce their expenses by the same amount but it still factors into the decision of a wife to work in the taxes economy or for in home consumption. If fact in Europe fewer wives work. It also adds to dead weight losses.

      • Too many not-for-profit hospitals are trying to be the world’s best, which doesn’t involve focusing on price. Just because an entity isn’t maximizing profit doesn’t mean they are more efficient.