Does Government-Provided Health Insurance Violate American Values?

According to Kent Conrad it does. Here he is talking to Ezra Klein:

EZRA KLEIN: How much of this is a product of political systems? Reid has a line in the book where he says the difference between America and France is that the French love their system and change it all the time. The Americans hate their system and can’t seem to touch it.

ENT CONRAD: It’s fascinating, isn’t it? I just don’t know. I’ve been trying to figure this out for a long time. I was very involved back in the ’90s reform effort. I was part of the Chafee-Durenberger centrist alternative to the Clinton plan. I’ve been searching ever since for models that I thought would fit America’s values and American culture. I’ve felt for a long time that a system that’s not government-run, but does have universal coverage, does a good job on quality and containing costs, and has the elements we see in some of these other countries is most likely to fit here and win political acceptance and be effective. Somehow in this debate, we’ve gotten very sterile. If it’s not public option, somehow it won’t be effective at providing competition to the insurance industry. I just don’t think that’s what the Reid book shows or what other observers of international systems would conclude.

As I read that I was saying to myself “but what about Medicare.” Fortunately, Ezra asked about this:

EZRA KLEIN: The question of values always runs into the existence of Medicare. You can imagine people saying that Medicare was simply too government-driven when President Johnson was trying to enact it. But Americans love Medicare.

KENT CONRAD: I’ve thought about that a lot. T.R. Reid’s book is so interesting on this point. Different parts of our system fit different models. Part fits the Beveridge model. Part fits the Bismarck model, where employers and employees contribute and it’s private doctors and hospitals. And other parts are national health insurance, which is Canada, and that’s Medicare. For our senior citizens, we have adopted the model that is closest to the Canadian model. But there are serious issues with that model if it spreads society-wide in terms of waiting times. I don’t think that fits American culture.

This is nonsense. Canadian waiting times are caused by budgetary issues. If they went up to our per capita level of Medicare spending, they would eliminate those waiting times. The relevant difference between US Medicare and Canadian Medicare is that we get more services because we spend more money, not that expanding the system to cover those under 65 would magically cause waiting times.

At any rate, a couple of questions later Conrad is back to talking about culture:

EZRA KLEIN: Do you support the public option?

KENT CONRAD: No.

EZRA KLEIN: Why?

KENT CONRAD: I go back to the T.R. Reid book. I don’t think a government-run plan best fits this culture. A plan that’s not government-run has the best chance of succeeding in being passed into law.

Conrad’s right, of course, that it’s easier to pass a bill that goes easy on for-profit interests than one that includes a public option. But that’s not because of “culture” it’s because of interest-group pressure. And of course one major practical problem with the public option is that powerful senator Kent Conrad opposes it. But Conrad doesn’t—or at least shouldn’t—get to cite his own opposition as the reason he opposes it.