This Atlantic article on our badly broken health care system by David Goldhill is very good. It makes the case, correctly, that the entire health care system should be totally different from how it is. I agree with a lot of it. But I think Goldhill is deploying his insights to the pretty insidious purpose of arguing against the kind of health reforms that now exist in the congress. The simple fact of the matter is that defeating the current reform effort is not going to lead to the emergence of some alternative, radically different health care reform. Defeat of the current legislative effort will demoralize proponents of health reform, teach politicians that any talk of modifying Medicare is politically toxic, and basically result in another 10-15 years of the status quo followed by some kind of budget crisis.
Passing the kind of ideas that are currently on the table would still leave us with a system with a lot of problems. But it would ameliorate several of those problems, and solve a few. It would also, I think, teach politicians the lesson that it’s possible to change the health care system. And that might lead to more and better reforms down the road.