A False Choice

According to David Brooks, the current health care bills in Congress will not significantly restrain health care costs:

But the general view among independent health care economists is that these changes will not fundamentally bend the cost curve. The system after reform will look as it does today, only bigger and more expensive.

As Jeffrey S. Flier, dean of the Harvard Medical School, wrote in The Wall Street Journal last week, “In discussions with dozens of health-care leaders and economists, I find near unanimity of opinion that, whatever its shape, the final legislation that will emerge from Congress will markedly accelerate national health-care spending rather than restrain it.”

Brooks then goes on to make a very valid point:

In these bills, the present Congress pledges that future Congresses will impose painful measures to cut Medicare payments and impose efficiencies. Future Congresses rarely live up to these pledges. Somebody screams “Rationing!” and there is a bipartisan rush to kill even the most tepid cost-saving measure. After all, if the current Congress, with pride of authorship, couldn’t reduce costs, why should we expect that future Congresses will?

But then he then puts the choice before us in a very strange way.

Reform would make us a more decent society, but also a less vibrant one. It would ease the anxiety of millions at the cost of future growth. It would heal a wound in the social fabric while piling another expensive and untouchable promise on top of the many such promises we’ve already made. America would be a less youthful, ragged and unforgiving nation, and a more middle-aged, civilized and sedate one.

Decent versus vibrant? Youthful versus aged? Unforgiving versus civilized? Is that what a good health care system entails by way of choosing what kind of society we want to be?

I don't see Canada or France being any less 'youthful' or 'vibrant' because they have a single-payer health care system. Canada's economy, for example, is in far better shape than ours right now. Their banking system was recently recognized as the best, most secure banking system in the world, because it was well regulated and cautious, unlike those in the U.S. Furthermore, they have a more vibrant manufacturing sector because they don't have enormous employer health care costs like we do but a more sensible, government run, taxpayer-based health system that covers everybody.

Brooks presents a very false and unnecessary choice in our health care debate. To allow our current system to continue unchecked and unreformed is a formula for national decline, bankrupcty, and collapse. We have no choice but to reform, in a way that both expands coverage and controls cost. That is task before us. Brooks may be correct that the current efforts don't achieve this, but that doesn't negate the need for real reform.