Health Care BS

One of the thorniest problems facing defenders of Obama’s new Medicare Czar, Donald Berwick, is how to explain away his views on health care rationing. In a 2009 interview, he delivered himself of the following remark:

The decision is not whether or not we will ration care; the decision is whether we will ration with our eyes open.

One way his defenders have sought to sanitize this clear endorsment of state-imposed rationing is to suggest that all informed observers hold the same view. To that end, Ezra Klein makes the following claim:

All health-care policy experts are experts on rationing. The question, as Paul Ryan told me, isn’t whether we ration, but who rations, and how.

But Klein is being dishonest. In the comment that Klein takes out of context, Ryan was merely making a point about the difference between government-imposed rationing and resource allocation via the market:

The question is who will do it? The government? Or you, your doctor and your family?

An honest reading of the February interview to which Klein refers makes it clear that Ryan repudiated Berwick’s view of rationing. He believes it should be driven by the informed decisions of consumers:

[R]ather than having government ration care to manage decline, let’s take those market signals that work in every sector of the economy to reduce cost and improve competition.

In other words, Ryan’s view of rationing is the opposite of Berwick’s. Ryan is a free market advocate, while Berwick is an old-fashioned central planner who thinks patients are too dumb to think for themselves.

The bottom line here is that Ezra Klein is not an honest man. Fresh from his Nixonian destruction of the Journolist archives, he’s now lying about Paul Ryan’s position on rationing in order to whitewash Berwick’s record.