There are all kinds of lazy problems in David Brooks latest column. I'll highlight a couple of his worst points:
Early in this health care reform process, many of us thought we were in that magical sweet spot. We could extend coverage to the uninsured but also improve the system overall to lower costs.
Would Mr. Brooks like to inform us what this Magical Sweet Spot Plan was? Because I've followed the debate closely, and I have no idea what he is talking about. I suspect neither does he.
Instead of reducing costs, the bills in Congress would probably raise them. They would mean that more of the nation’s wealth would be siphoned off from productive uses and shifted into a still wasteful health care system.
Brooks is using the word "costs" deceitfully here . He is talking only about what health care "costs" the government takes on, while not including the private dollars that you and I spend on health care. But both private and public costs are part of the same health care system that is the most expensive in the world. Brooks ignores the fact that if the government spends more on health care, middle and working class costs can be reduced. For example, Brooks would say a single-payer system "costs" more. And it does cost the government more. But it costs the average person less.
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.
And he quotes the Wall Street Journal. What, was Fox News busy? In fact, many economists do believe it will bend the cost curve, see Ron Brownstein's article. Back to Brooks:
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?
Wake up David Brooks, you might have missed something! Over to you Ezra Klein:
But Congress has made tough decisions before. The House, for instance, just voted to cut $500 billion from Medicare to reform the health-care system. The Senate is expected to cut a similar amount, and also create a new institution to make future cuts easier. Hard votes often fail, but they occasionally succeed.
Brooks also does not mention that the Senate bill creates a Medicare Commission with strong powers to cut medicare costs. Under this provision of the bill, Congress must each year vote on the Commission's entire package of reforms without getting to tweak it or add pork, with no fillibusters allowed, or Congress has the option of proposing equivalent funding cuts in other areas. That sounds about as airtight a cost-cutting system as there can be! What does Brooks want Congress to do exactly if this is not good enough for him?
Maybe Brooks would answer, "Whatever. Congress will find a way not to make the cuts." You know, Brooksy, at that point.....well, Ezra says it best:
It's possible, of course, that Congress will still reject the ideas. At that point, however, it's pretty much time to give up and go home. If there are no circumstances under which Congress will reform Medicare, there are no circumstances under which the federal government will not go bankrupt.
It seems to me that this health care bill is the best we can expect from a money-larded system in a democracy of 300 million people. And in a lot of ways it is pretty good. But its not perfect, and of course people like David Brooks will use its downfalls to try to kill the bill. But I agree with Ezra--if this bill fails, then we really are screwed. We might as well give up and go home. With the stakes so high, it seems to me a mark of partisan unseriousness to be David Brooks and so lazily and inaccurately write about this bill.
No comments:
Post a Comment