The Central Paradox of Health Care Reform

The big problem, politically speaking, with health care is that you basically have people on the left arguing both sides of the question. On the one hand, insofar as your plan is “big government” that’s left-wing. But insofar as your plan is expensive, that’s also left-wing. Which is because people normally think of big government programs as expensive. But when it comes to health care, heavy-handed government intervention is actually way cheaper than private sector alternatives. Consequently, every time you try to make the plan more “moderate” by, for example, curbing the influence of a public option you actually wind up making the plan more “left wing” by needing to raise more taxes. And if you want to make the plan cheaper, while still actually achieving its goals, then you need to make it more left-wing not more moderate. But in the United States, ideological correctness and special interest politics prevents us from admitting this.

When the Lewin Group looked at various health proposals last year, it turned out that the one that did the best at controlling costs was Pete Stark’s bill:

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Creates a new public health insurance program administered by the federal government to provide everyone with multiple choices for health coverage. Under the Stark bill (H.R. 1841), employers would either offer their employees coverage or pay into a fund to cover their employees through the new public program.

Needless to say, that kind of reform is off the table. “Political reality” and all that.