The elderly bobby-soxer of TAP, as Mark Steyn aptly describes Ezra Klein, inadvertantly exposes the essential paternalism that animates the single-payer project:

Liberal solutions don’t try and force the individual into a governing role he or she is not equipped to assume.

In other words, the hoi polloi are simply too stupid to make their own health care decisions, so their betters in government must do the heavy intellectual lifting. 

Andrew Sullivan responds by pointing out the obvious fact that, even if these bureaucrats are “the most honest, decent, and committed public servants in the history of the nation,”

They’re still going to be subject to a variety of outside incentives … Those bureaucrats may not be elected themselves, but they’ll be appointed by elected officials.

And those elected officials will be under increasing pressure to impose health care rationing in the name of “cost control”:

Concerns about costs also lead to regimes like the one in Britain, where the NHS has been known to make medical treatment conditional on patient behavior.

As an alternative to such soviet-style managment of the health care system, Sullivan advocates opening up health insurance markets, linking to this excellent post by Peter Suderman.

At the heart of Sullivan’s position is his confidence that the average patient is intelligent enough to make his own health care decisions. Klein’s position exposes the contempt that he and other “progressives” have for “the people.”

Sullivan is right and Klein is, as usual, wrong.

Comments 14

  1. drmatt wrote:

    You mean to say the average individual has the ability and know how to navigate Insurance industry and policy, medical statistics and standards, government policy and mandates to be able to get the most for themselves?
    Dear Lord Catron! you have made a whole career of dealing with these institutions, the existence of YOU is testament to the fact that this is not an idividual job! and for that you take comments out of context and Malign Mr. Klein? note he also said,

    “An actual solution will require reforms far above the level of the individual. The incentives of providers will have to be reworked to prize wellness over profits, or at least to align profits with wellness, rather than simply with treatments.”

    Again you have skipped over the point of the article to push your agenda, you should run for office, you clearly work the same way as your average politician.

    Posted 20 Feb 2008 at 8:42 am
  2. Ed Sodaro MD wrote:

    Excellent post. The “soft totalitarians” like Ezra Klein, Hillary, Obama, or their mind-numbed robot followers would have you believe that the people who run the Dept. of Motor Vehicles or the Post Office can micromanage the most complex and personal of decision making processes to which humans are subject!

    You know, even the Post Office was forced to have a two-tiered system for a simple job like providing its monopoly market in passports. For a basic outrageous high fee, you wait only six months for something that should take six minutes to accomplish. If you pay an even more outlandish fee, you get the bureaucracy to give it to you in a sixth of the time (still breathtakingly incompetent).

    Consider passports as the precise model of Canadian or democrat party care. Amazingly expensive for abyssmally bad service.

    Posted 20 Feb 2008 at 9:30 am
  3. Catron wrote:

    “You mean to say the average individual has the ability …”

    The avg individual can buy a laptop computer that is infinitely more complex than the technology that got us to the moon.

    Besides, as Dr. Sodaro points out, the people who run the DMV are not going to suddenly become competent when entrusted with our health care.

    Posted 20 Feb 2008 at 10:50 am
  4. drmatt wrote:

    As far as I know, nobody’s LIFE depends on a laptop. Thus the need to be proficient is minimal, furthermore you can get your money back if you mess it up, I dont think you can get your life back. Dr. Sodaro is obviously confused, whenever the govt has opened a new commision they have hired people knowlegable in the field not transferred people from the DMV!!! nice rhetoric but it assumes we are all stupid!! Talk about paternal.
    i.e. did the DMV start NSA, FBI, SS? DOE? HHS? ATF? not only is he pointless, his assessment is baseless

    Posted 20 Feb 2008 at 11:11 am
  5. Marc Brown wrote:

    You are confusing two things David – the imperative for patients to make informed choices, which should be a cornerstone of modern medicine, and the provision of an evidence base and a system to provide those choices (where it’s certain that many insurance plans limit choice). The latter will always be subject to expert input and regulation, unless you’re advocating unleashing a squad of Dr Mengeles on the public. Come to think of it, you are rather extreme…

    Posted 20 Feb 2008 at 12:27 pm
  6. Catron wrote:

    “Unless you’re advocating unleashing a squad of Dr Mengeles”

    Ironically, the regime that actually unleashed Dr. Mengele was, like you, anti-market. Here’s Jonah Goldberg on the subject:

    The Nazis were socialists. The Nazi ideologist Gregor Strasser put it succinctly: “We are enemies, deadly enemies, of today’s capitalist economic system …” The speech that first attracted a young Adolf Hitler to fascism was titled “How and by What Means Is Capitalism to Be Eliminated?”

    Posted 20 Feb 2008 at 12:58 pm
  7. drmatt wrote:

    whoa, Let’s jail those Nazis that also started the public school system in the US!!! Those anti-market bastards!!!

    Posted 20 Feb 2008 at 1:12 pm
  8. Ed Sodaro MD wrote:

    “Dr. Sodaro is obviously confused, whenever the govt has opened a new commision they have hired people knowlegable in the field not transferred people from the DMV!!!”

    Wow, I did not literally mean that people would be transferred from the Post Office or DMV to micromanage Obama healthcare! Amazing!

    But we do have actual living horror-show examples of how The Anointed Ones and their troll advocates would treat people in US government health care systems: The Indian Health Care System, the Community Mental Heath Care Clinics, and the VA.

    And citing ATF, SS, DOE and so forth does not in the slightest strengthen any argument for government efficiency or competence! LOL!

    Posted 20 Feb 2008 at 1:23 pm
  9. drmatt wrote:

    Yeah, your right, I think we should let monetarily motivated business men make our health care decisions..GOOD IDEA, you will be up for a nobel peace prize I am sure.

    Posted 20 Feb 2008 at 1:49 pm
  10. Matt Horn wrote:

    Why not drmatt? If they don’t do a good job, people will go to their competition and they will be out of business. The free market is generally self regulating to the benefit of the consumer when government is taken out of the picture. Only problem is, it shows the warts of “progressives.”

    Posted 20 Feb 2008 at 2:45 pm
  11. drmatt wrote:

    #1 If you dont do a good job in a heart attack, cancer, stroke, pneumonia, renal failure or thousand of other possibilities you can’t go to the competition, it is too late, you are dead.
    #2 The money made in health care year after year, decade after decade comes from the healthy and the well off, the rest of the population is a losing proposition for money minded business men, i.e. people who are really sick cant work, thus cant make money thus cant pay the bill.
    #3 The reason that I went out of business in medicine is that I treated every person who walked through my door, Cant see turning people away because they cant afford it. try it sometime, try looking that little old lady in the eye who has crappy medicare, who’s children and grandchildren you care for and know well and say, “sorry, despite the fact that I am trained, competent and available I am not going to help you because you can’t afford me”

    Posted 20 Feb 2008 at 2:59 pm
  12. drmatt wrote:

    PS I did notice how the free market benefited me with planned obsolesence, the recurrent burying of information that would notify me of danger or significant problems with a product, the shipping of our manufacturing jobs over seas, the holding back of important patents until there is “market saturation” of a companies current product, or patents that increase fuel efficiency, these would all be great for health care being self regulating and all.

    Posted 20 Feb 2008 at 3:03 pm
  13. Marc Brown wrote:

    Drmatt, our friends seem to be under the delusion that free market incentives are to provide universal care, when in fact they are to maximise profit from the most profitable. Do you think they should be seeing a doctor for their condition, or is it terminal?

    Posted 20 Feb 2008 at 4:45 pm
  14. Matt Horn wrote:

    #1 insurance companies are not known for practicing medicine, they just pay for what is in the contract,
    #2 Insurance is a risk industry. If there was no risk, there would be no insurance.
    #3 I can’t manage your practice for you, but it sounds like your own decisions, however well intentioned, were the casue of your failure. Note that those decisions also adversely effected your staff. There is a responsibility of stewardship to them as well. We can’t be all things to all people.

    PS: Those are all great examples of the free market drmatt. Burying of product information, like the tags on a hair dryer that warns people not to use it in the shower, or the indications on Phen-Fen that say it should only be used on the morbidly obese, as significant cardiac issues could occur? Insulating us from stupidity and misuse. These are put on by manufacturers to limit their liability when brain-dead morons misuse their product.
    Shipping jobs overseas, well when the tax code becomes confiscatory and wages are artificially inflated, the market moves towards equilibrium. I’m sure you wouldn’t mind paying $400 for a pair of sneakers so a high school dropout can make a “living wage.” no?
    Holding back patents? I am not sure what you are talking about. Maybe the Pogue carburetor or Meyer’s water car?

    Posted 20 Feb 2008 at 4:50 pm

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