Ezra Klein Misses the Point Again

Ezra Klein has a piece in the Washington Monthly in which he predicts failure for state-initiated “universal health care” reform:

The history of state health reform initiatives (and there’s quite a history) is a tale of false hopes and great disappointments … Universal care advocates must be realistic about that, and think hard about how to convert the energy in the states into a national solution before the current crop of novel experiments fail—because fail they almost certainly will.

For once, Klein is right. Typically, however, he misses the point. Rather than drawing the obvious conclusion that socialized medicine, like socialism in general, contains intrinsic flaws that render its eventual failure inevitable, he sees the probable collapse of these state programs in purely tactical terms:

If high-profile efforts like those in Massachusetts and California can’t be properly implemented, or are launched and then collapse, they’ll become powerful weapons in the hands of protectors of the status quo.

And how would these fiendish “protectors of the status quo” use their “powerful” weapon?

After the demise of Washington State’s plan, for instance, the Heritage Foundation published an article stating that the program “gave state legislators around the country an experimental taste of how a Clinton-style health care plan would work—or fail to work. The result was higher costs, burgeoning bureaucracy, and micromanagement.”

In other words, these soulless minons of the “health care industrial complex” would tell the truth. Have they no shame?!

If Klein and other advocates of socialized medicine would spend less time avoiding the obvious realities of government-run health care and more time exploring workable solutions to the problems bedeviling American medicine, they might actually make a useful contribution to health care reform.

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Comments 11

  1. SteveH wrote:

    Well, bravo for being one of the few conservatives that allows comments on their site. However, the “obvious realities of government-run health care” is that it costs less and produces better results. If only opponents of “socialized medicine” would spend more time looking at what really works in other countries, they might actually make a useful contribution to health care reform.

    Posted 10 Jul 2007 at 4:41 pm
  2. Matt wrote:

    We get it, socialized medicine won’t work in your opinion. We also get that you don’t like the current system.

    What is your contribution to health care reform, Catron? How would you propose we change things?

    Posted 10 Jul 2007 at 8:20 pm
  3. Catron wrote:

    Matt, the big items would be deregulation and tax reform. The right changes in those areas would eliminate many of the perverse incentives that have the system out of whack. For more on what should be done, read this.

    Posted 10 Jul 2007 at 8:45 pm
  4. Catron wrote:

    Steve, you have proven my point by making gratuitous assertions that aren’t remotely “reality-based.” Socialized medicine lurches from one disaster to the next pretty much everywhere it has been implemented. Some examples I have provided recently can be found here, here, and here.

    Posted 10 Jul 2007 at 8:57 pm
  5. SteveH wrote:

    I’m sitting in a hotel and had nearly completed a response when someone kicked the power cord and away went my links and reply. Here goes again.

    Catron, you don’t seem very familiar with the peer-reviewed health policy literature. The Fraser Institute and blogs don’t make it. If you look at actual surveys and comparisons of care in different countries you’ll find that other countries with universal care aren’t stumbling from disaster to disaster, and they certainly aren’t facing the disaster of having about 16% of their population lacking coverage. Outcomes are similar to or better in most areas as the US health care system, at far less total costs. Those are facts.

    International Comparison: Access & Timeliness
    How does the United States compare with other countries on patient-reported access problems, continuity of care, and waiting times?
    In a 2005 survey of sicker patients conducted in six developed countries, the United States ranked last on four measures of continuity of care and access problems reported by patients.
    http://www.commonwealthfund.org/snapshotscharts/snapshotscharts_show.htm?doc_id=409110

    How Does The Quality Of Care Compare In Five Countries?
    Health Affairs, 23, no. 3 (2004): 89-99

    It will come as surprise only to those who are ideologically wedded to some theory that some countries do well in one area and less so in some others. But considering the huge difference in health spending, the fact that the US does poorly in so many areas should be a warning that things aren’t great here compared to all the other theres.

    Catron you can cherry-pick data or anecdotes, and in this you aren’t any different from Michael Moore, but the fact remains other countries have decent health care systems that produce acceptable to excellent results at lower cost.

    Posted 11 Jul 2007 at 10:43 am
  6. Catron wrote:

    Sigh …

    They certainly aren’t facing the disaster of having about 16% of their population lacking coverage.

    Insurance coverage isn’t health care. The inability of the “reality-based” community to grasp this reality is a constant source of amusement for me.

    Outcomes are similar to or better in most areas as the US health care system, at far less total costs. Those are facts.

    The Commonwealth Fund is an advocacy group whose methods of data collection and interpretation are open to considerable question (see this). Health Affairs, sadly, does little but parrot what the Fund feeds it.

    Posted 11 Jul 2007 at 11:02 am
  7. SteveH wrote:

    Well cool dude. If patient reports are generally worthless, than the criticism that Michael Moore didn’t mention that the US is No. 1 is worthless because people’s opinions don’t count. You’re left to fall back on population based stats, like infant mortality and life expectancy and you already know what those say about the US.

    And access and coverage aren’t the same, but I’d be happy to break your kneecap if you will proceed to an ER and tell them you don’t have any health insurance and then see what happens.

    Posted 11 Jul 2007 at 11:57 am
  8. Catron wrote:

    I hate to be the one to break this to you, but your talking points involving infant mortality and life expectancy aren’t valid either. This will explain why.

    As to the ER, my broken kneecap would be treated without regard to my ability to pay. EMTALA guarantees that.

    Posted 11 Jul 2007 at 2:19 pm
  9. Morris Berg wrote:

    Um . . . David . . . you may be want to re-read EMTALA and specifically the definition of “emergency.”

    If really necessary to preseve life or limb you may get some “stabilization,” but otherwise, um . . . nah. Oh . . .and it also has to be

    You really should read these things, David, lest you sound as though you know not of what you speak . . . and especially if you lose your insurance and then piss off some stereotypical cliched mobster, who I hear really get angry when people speak out their arse about EMTALA.

    Posted 11 Jul 2007 at 3:38 pm
  10. Morris Berg wrote:

    Oh and I also should complete my sentences . . . mobsters hate that too.

    Posted 11 Jul 2007 at 3:38 pm
  11. Catron wrote:

    Actually, I have not only read EMTALA, I live with it every day. Here’s how it works:

    Every patient who crosses the threshold of the ER receives a medical screening before anyone asks any question about insurance or payment. And this medical screening isn’t mere triage. It is conducted by a physician and may include such things as blood work, x-rays, CT scans, etc.

    If it is determined that the patient’s condition isn’t emergent, then the hospital is permitted (in theory) to ask the patient for payment before proceeding with further treatment. In actual practice, this almost never happens. The ER docs are so afraid of malpractice litigation that they just go ahead and treat the patient regardless of acuity.

    So, despite what you read in the paper or on the web, it is a myth that patients are sent away from the ER untreated.

    Posted 11 Jul 2007 at 8:12 pm

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