A variety of “progressive” health care analysts are still deluding themselves about the future of “universal” health care. Ezra Klein, as I wrote last week, is as clueless as ever on this point, and Maggie Mahar’s most recent post makes it clear that she is still out in fantasyland:

Perhaps we are entering a new era, where we will be able to do things that we haven’t been able to do in the last 28 years.

Like all cases of self-delusion, those of Klein and Mahar require that they ignore mountains of contrary evidence. They have refused, for example, to absorb the obvious lessons of the SCHIP debate and the demise of Oregon’s ”Healthy Kids” initiative.

They will no doubt continue this pattern of denial and ignore the death of Arnoldcare. As reported in the WSJ, California’s Democrat-controlled legislature finally did the humane thing for this writhing, moribund beast:

Arnold Schwarzenegger’s “universal” health-care plan died in the California legislature on Monday, in what can only be called a mercy killing.

Anyone not impervious to objective data will notice that the death of Arnoldcare, “Healthy Kids,” and SCHIP have one item in common. They occurred in legislative environments controlled by DEMOCRATS:

The California legislature is probably the most liberal this side of Vermont, and even Democrats refused to become shock troops for this latest liberal experiment.

Why? Because they can’t pay for it.

Like collapses in Illinois, Wisconsin and Pennsylvania, this one crumpled because of the costs, which are always much higher than anticipated.

No matter how much BS is piled up by the advocates of universal health care, the goals of unlimited access and low cost are mutually exclusive. You can have one or the other, but you can’t have both:

You can’t make coverage “universal” while at the same time keeping costs in check — at least without prohibitive tax increases.

This is the rock on which Oregon’s plan wrecked, and why Nancy Pelosi and her accomplices had to promote a tobacco tax scheme that would have created the need for new smokers.

So, what does this mean for the fantasies of Klein, Mahar, and others of their persuasion? It means that, even if the voters are foolish enough to put Hillary in the White House this November, no overhaul of U.S. health care will ensue.

Comments 23

  1. drmatt wrote:

    “You can’t make coverage “universal? while at the same time keeping costs in check — at least without prohibitive tax increases.”
    Sad to see you so underestimate the people of this great nation, thier intellect, tenacity, and fortitude. I can see where you would have been standing at the first discussion of a revolution against the tyranic rule of King George………… truly a non patriot.
    no doubt those plans failed or where voted against. WOW I guess that means we CAN’t provide affordable quality healtcare to all amercian citizens, let’s just bend over and take what corporate health insurance, liability and the ever gentle pharmaceutical industries give us.

    Posted 30 Jan 2008 at 12:14 pm
  2. Catron wrote:

    “Sad to see you so underestimate the people of this great nation …”

    The people aren’t the problem. The laws of economics are the problem.

    We could, however, provide affordable health care to pretty much everyone if we got rid of the perverse incentives created by the federal and state bureaucrats.

    Posted 30 Jan 2008 at 1:01 pm
  3. Brad F wrote:

    I have been reading Healthbeat (Mahar) for sometime, along with many others. I am neither on the right nor the left of the health care debate and favor a hybridized solution. I can certainly say that while Maggie favors a more progressive approach to the fix, her posts consistently emphasize costs and the rot that pervades the system. She gets it. You may not agree with everything she writes, but fantasyland. Sorry, mischaracterization.

    Posted 30 Jan 2008 at 1:10 pm
  4. Catron wrote:

    “She gets it.”

    There are many aspects of health care economics that she most emphatically doesn’t “get.”

    That’s not because she isn’t smart enough, but rather because she is so blinded by her ideology that she simply can’t see certain realities.

    Her inability to face the facts on the ground as they relate to “universal” health care keep her trapped in … well … fantasyland.

    And she is not by any means alone in this. Most “progressives” are similarly hobbled.

    Posted 30 Jan 2008 at 1:21 pm
  5. drmatt wrote:

    How about providing an example of the country or system where there is a complete free market medical system that is following your “laws” of economics and providing affordable quality health care to all?
    you cant, it doesnt exist, hmmmmmmmm I wonder why. who is living in fantasy land?

    Posted 30 Jan 2008 at 3:13 pm
  6. Catron wrote:

    “How about providing an example of the country or system where there is a complete free market …”

    There IS no country that has a free health care market. That includes the US. Thus, you have no objective data to support your belief that a market-based system won’t provide affordable and equitable care.

    We do, however, have examples of health care services whose markets are left unmolested by the government. And guess what? Prices have gone down and access has increased. Hmm, indeed.

    And, BTW, they aren’t “my laws? of economics any more than gravity is “my law? of physics.

    Posted 30 Jan 2008 at 3:38 pm
  7. drmatt wrote:

    Sorry, I know they are not your laws, in fact using the word laws is a misnomer, if they were truly laws (as in physics) the economy would always be predictable, as it turns out, it never is, all you have are guesses, I would not build a health care system on guesses, nor do I think anyone should. By the way, don’t you think there is a reason not a single country on the entire planet has set up a free market system? Recipe for disaster, that’s why. As for your examples, I am sure they are trite at best.

    Posted 30 Jan 2008 at 4:00 pm
  8. Catron wrote:

    “Using the word laws is a misnomer.”

    They are indeed natural laws, just as immutable as the laws of physics. Read your Adam Smith, dude!

    The economy IS predictible. That’s why price controls (as in Medicare, Medicaid, etc.) always produce the predicted shortages (as in primary care physicians).

    Posted 30 Jan 2008 at 4:12 pm
  9. drmatt wrote:

    if the economy is predictable why do people ever lose money on wall street? why aren’t recessions and depressions nipped in the bud, why aren’t all people who endeavor with in it prevail? they are actually not natural laws, and I am not the only one who is not impressed with adam smith.
    So let me get this straight, your plan is to turn medicine over to a free market economy that is obviously complex, (while medicine is also complex) with absolutely no objective evidence on what the outcomes will be? (your the one who said there is no evidence by the way), bold, and collosally stupid.
    thanks for calling me dude, makes be feel young (even if it is fake).

    Posted 30 Jan 2008 at 4:39 pm
  10. drmatt wrote:

    by the way, for every “law” of economics that you quote I can give you real examples of where it didnt apply, which by virtue makes it not a law. no doubt you will retort with “it’s not that simple” therein lies the problem, there not laws, and it is not simple.

    Posted 30 Jan 2008 at 4:41 pm
  11. Matt Horn wrote:

    Economics is a science, thus the law of decreasing marginal utility is an actual natural law that can be proven in any case. Problem is that these laws are not PC and not sensitive. That is a problem, when the people on the other side of the argument are ignorant of this fact.

    Posted 30 Jan 2008 at 4:49 pm
  12. Rich wrote:

    Even the laws of physics acknowledge chaos, probability, and uncertainty (see Heisenberg).

    But they are still useful.

    Posted 30 Jan 2008 at 5:22 pm
  13. Catron wrote:

    Two books, drmatt: The Wealth of Nations (Adam Smith, 1776) and The Road to Serfdom (Friederich Hayek, 1944).

    If you read them with an open mind, they will change your life. Indeed, you may come over to the dark side … bwahahahahaha

    Posted 30 Jan 2008 at 6:52 pm
  14. drmatt wrote:

    The law of diminishing (I believe diminishing is the correct word here, not decreasing) marginal utility is a notion that marginal utilities are diminishing across the ranges of relevant decision making, however, read further and most authors who discuss this also write, “it will not always hold”, or something to that degree. Please tell me when gravity doesnt hold? when biochemestry, kinetics, light, radiowaves or any other phenomenon described by physics does not hold? In regards to chaos theory, awsome stuff, describes in many ways, phenomenon that we previously have been unable to describe, but it does not operate outside of the laws of physics, it only displays a new application. cmon guys.

    Posted 31 Jan 2008 at 6:29 am
  15. Rich wrote:

    ‘discuss this also write, “it will not always hold?, or something to that degree’

    Citation, please.

    Choas & uncertainty are not new applications of the same laws. They are revisions to the basic knowledge of physical laws which acknowledge that there is uncertainty, and that many physical phenomon are best described probabilistically, rather than deterministically.

    But such is the case in Medicine as well, so you should know that.

    Posted 31 Jan 2008 at 8:45 am
  16. drmatt wrote:

    Chaos, probability and uncertainty are all based on the infintismal number of variables and how they effect the behavior of the thing being studied (not to mention the unpredictability of the presence and effect of such variables0, they are NOT descriptions of changes in the basic laws, and of course this applies in medicine, variables are what make medicine an art as much as a science.
    will need time on the reference, gleaned it from my undergraduate notes (never did write references in my notes)

    Posted 31 Jan 2008 at 10:34 am
  17. Rich wrote:

    In theoretical physics, chaos and probability are not a property of the observer or of the observers lack of knowledge of the variables involved, they are inherent in the system.

    It is, in fact, what makes quantum mechanics, quantum mechanics.

    Oh well. It’s irrelevant.

    If laws of science were deterministic, than objective data would be enough to convince those who otherwise apply the sciences selectively. But it is apparently not the case.

    Posted 31 Jan 2008 at 11:42 am
  18. Matt Horn wrote:

    drmatt, I see you knew exactally what I was referring to even though I was typing too fast. I would also like a citation as to when that law would not hold. Yes the associated curve may shift, but it will always hold. Maybe that is what you were trying to say.

    Posted 31 Jan 2008 at 11:59 am
  19. drmatt wrote:

    I understand the theory, it is not deterministic only because it is unpredictable (often referred to as the butterfly effect, in this case the flap of the butterfly’s wings being the unpredictable variable to push action to a critical mass) because the variables are immeasurable, unpredictable and minute (and part of an uncontrollable system) this does not mean that the variables and effects of variables do not follow the laws of phsyics!!!! In fact the attempt at chaos math equations, quantum physics etc, is to apply the laws of physics to those variables in a way that can be repeated and reproduced.

    Posted 31 Jan 2008 at 11:59 am
  20. drmatt wrote:

    Sorry matt, you have reached the extent of my knowlege on economics, the reference is from an undergraduate notebook i kept for class, and undergraduate was a long time ago, so exactly what the professor was referring to is outside of what my early alzhiemer’s betz cells can retrieve. non the less, my memory serves that the “laws” of economics are not near as predictable as say, gravity, speed of sound, or other physical concepts, and thus do not warrant the title LAW. In example, When it comes to economics, you can find as many economists to say that one thing will happen as another? you wont find this for gravity, speed of light etc. etc. etc. It almost seems closer to philosophy or psychology (which wouldnt suprise me being that it appears to be in some measure, another way to look at human behavior, which as we no is on certain in it’s unpredictability).

    Posted 31 Jan 2008 at 2:39 pm
  21. Rich wrote:

    aaaa.. Bohr and Heisenberg are rolling over in their respective graves.

    They do follow the laws of phsyics. Where we disagree is apparently your notion that given sufficient improvements in our knowledge and instrumentation, these systems become deterministic – which is incorrect. They are inherently probabilistic. Einstein, who was a detractor of quantum theory, characterized his doubt about it by saying “I do not believe G-d would play dice.” Nevertheless, the data in support of quantum theory has grown immensely since Einstein’s passing, and apparently, G-d does play dice.

    But this tangent really belongs on another blog. Sorry David.

    Posted 31 Jan 2008 at 2:49 pm
  22. Matt Horn wrote:

    I will maintain my tangent for one last post. Economic laws are truly laws. The divergent opinions are theories based on those laws, (and sometimes destroyed by those laws.) The rules hold for those from the Austrian school, Marxists, Supply-Sideers, Keynesiens, mercantilists, etc. The problem comes with the predictive modeling, as there tend to be a significant number of variables and unknowns. As a matter of fact, one predictive model I used would track curves on over 25,000 axis and put them into a single curve. (The most I plotted was 100, It took three weeks!)

    Posted 31 Jan 2008 at 3:30 pm
  23. drmatt wrote:

    You are right, this would be best on another blog, although i imagine a blog dedicated to this would be far beyond where I could join in.
    I too apologize david, graciously.
    one more thing though
    rich you wrote
    ‘Choas & uncertainty are not new applications of the same laws. They are revisions to the basic knowledge of physical laws which acknowledge that there is uncertainty, and that many physical phenomon are best described probabilistically, rather than deterministically.

    an now you right “they do follow the laws of physics”

    I dont see that we disagree, I do see that you disagree with yourself, first you say that chaos is a revision of basic knowlege of the laws, which it most certainly is not, it is a new application and an overall admission of our inability to adjust for everything, (light, heat, soundwaves, particals, gravitational fields etc. etc. etc) there is no revision of the basic knowlege.
    Though, being a science fiction fan, i do like to fantasize about a day when we can adjust and control for all variables, who knows maybe another million years or so.

    Posted 31 Jan 2008 at 3:35 pm

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    Cost or access: Choose one or the other…

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