• Why is this so hard to understand?

    I’ve written this so many times, I fear someone will start accusing me of plagiarizing myself. Yet it seems that it’s still a mystery to some.

    There are many things that government is good at with respect to health care insurance. It’s great at making sure everyone is covered. It’s also great at keeping spending under control.

    There are some arguments to be made about what government is not good at. There are some who believe it doesn’t promote good quality (although I disagree). There are some who fear that it stifles innovation (often because it’s good at keeping spending down). There are some who dislike that it limits choice.

    But it’s good at keeping spending down. That’s why Governor Romney gets caught up in a “gaffe” when he talks about Israel’s health care system. It keeps spending so low because it has a lot of government cost controls.

    But because we’ve gone through the looking glass here in the US, you get people arguing that government is bad at cost controls,and that we can save money by eliminating them. That’s just… bizarre.


    • It makes more sense when you recognize that many of the people making that argument don’t actually want cost controls and are quite happy with the government and private sectors each spending what the government alone would have to spend for a national health system of equivalent quality. The near-trillion in extra cash goes disproportionately to the wealthy. Block granting Medicaid takes some money out of doctors hands, but it also gives states more leeway to afford recent, dumb tax cuts that everyone will be shocked to realize don’t pay for themselves.

      Nearly every Republican health proposal shifts the American income redistribution regime to the top. Not so bizarre. Maximum utility of combined American spending on healthcare simply isn’t a Republican priority.

    • I’d agree that it’s not a R priority and, as many others have pointed out, it’s why they still don’t have a cogent theory/plan today. That said, the R plans that are out there (premium support, tax credits) seem to look a lot like global budgets.

      As for Aaron’s point, I’m not even sure what the debate is. It’s really clear that if containing health care spending is your top priority, government can do that.

      • “That said, the R plans that are out there (premium support, tax credits) seem to look a lot like global budgets.”

        Exactly. In fact, that is the only global budget game in town (DC) at the moment. ACO (or HMO without commitments) has a global budget for a given diagnosis, but is a long way away from a per-capita global budget.

    • It is bad a licensing due to regulatory capture. It seems rather knee jerk at regulation also.