23
Mar
10

Calm down; have some dip

I know it’s not very amusing to be the patient voice of reason for two posts in a row, so I’ll try to work some snark into this one.

By now the great migration of the Drama Llamas is in full stampede over most of the big truck.  A significant proportion of the red-staters — “omg wtf it iz teh socialism nao” — and a significant proportion of the Reds — “haha lulz it iz teh socialism nao” — are blogging, literally or figuratively, like /b/tarded lolcats.  Whether anything useful is being said in all the wailing and the gloating is, of course, somewhat obscure.

It will not surprise the careful reader to learn that Russ Roberts is saying intelligent things about health-care reform.  I’ll go through and summarize, but you really ought to read the originals.

The current system of health care—a mish-mash of top-down regulation and private attempts to respond to it—is bankrupt, both intellectually and financially.

We haven’t moved from a system of brilliant free-market health-care dynamism to a stultified centrally-planned Orwellian nightmare.  We’ve moved — probably; let’s face it, most of the people (your humble author included) bloviating about the HCR bill haven’t read it and have no good idea of what’s in it — from a system of crony corporatism mired in regulation to a system of crony corporatism mired in a fair bit more regulation.  And a lot of the old regulations have changed, which’ll cost health insurance companies a lot of money to respond to… which will, of course, get passed down to the consumer.

People like having other people pay for their health care. They don’t see that that drives up the price and makes it harder for poor people without insurance to pay for health care.

See also: employer-paid health insurance tax subsidy, the.  Again, we’re not being dragged from minarchotopia into Oceania.  The HCR bill fiddles with a bunch of existing transfers and establishes some new ones.

The existing legislative promises of Medicare and Social Security are a train wreck that cannot be avoided without radical change. Expanding coverage just brings the train wreck closer.

It also makes the train wreck easier to see, because we’re no longer looking at the status quo.  At least, that’s what I’m hoping (and I’ll support that position further down this post).

After a typically insightful Robertsian parable, he concludes:

The new world of health care is going to redistribute wealth from rich to poor. The existing system has all kinds of redistribution in it, too. It’s just harder to see.

(Emphasis added.)

Maybe I’m just bitter over the individual mandate, but I have a hard time seeing how redistributing wealth from healthy young people to sick old people is “from rich to poor” — wealth tends to increase with age.

The larger point, however, should be well-taken.  Pulling a half-formed example out of my ass: one reason why prescription drugs are so expensive on the American market is that the (for example) Canadian market is able to negotiate extraordinarily tough deals by virtue of its single-payer structure — the American prescription-drug market has to be profitable enough to compensate.  The effect, I imagine, is similar to the disconnect between employer-pays group insurance and private-market individual insurance.  Thus do the pants subsidize the hat.

Moving on to the what the hell did we just vote in? segment of the post, we find this from Reason’s Hit & Run blog:

As the Center for Science in the Public Interest (CSPI) reminds us, the health care bill that will soon become law includes a requirement that restaurant chains with 20 or more outlets conspicuously display calorie information on their menus and menu boards.

Remember when people used to smoke, and then the tobacco companies had to put warnings on cigarette packs and no-one smokes any more?  It’ll be just like that.

Commenter Nick points out the offsetting-behaviour elephant in the room line at McDonalds:

I will enjoy the fits the do-gooders have when people stop eating responsibly because they have free health care.

Social control is an iterated game, so some sort of ban on fast-food consumption seems like the obvious counterstrategy by Caring People.  It worked so well on alcohol and drugs, too!

Back to that train wreck:

Sullivan quotes Ross Douthat:

I’ve talked to liberals who seem to understand this: The reckoning is coming, they allow, and the theory of health care reform has always been to get everybody inside the barrel before it goes over the falls. (I’d lay good money that this is Peter Orszag’s view of the matter.) But seen in this light, the health care victory looks less like the dawn of a bold new era, and more like the final lurch forward before a slow retreat.

and adds his own blend of wishful thinking (much like mine):

Or rather, surely, to embark on long-term, dead serious fiscal reform, while making sure the poorest and those most struggling in the barrel are kept on as equals, not cast aside as burdens. In the big fiscal task ahead, we’ll need a sense of fairness as well as strictness if we are to persuade a majority – rich an poor – of necessary but painful change.

If this HCR bill prompts actual useful entitlement reform before the country gets to the point that Greece just reached, I’ll sing its praises naked from the rooftops.

Just to scrub that image from your mind’s eye, I’ll end with some words from a recent post by Ed Glaeser:

(h/t Austin Frakt)

The health care bill with its mandates, new regulations and increased spending has brought forth a surge against the state, but sensible health care reform requires more than just saying no.

From a purely libertarian perspective, the status quo — with its vast and growing public health care expenditures — was no nirvana.    Pure libertarians will never succeed in just wishing the government out of health care, but pragmatic libertarians may be able to push more modest reforms that can make the public role in health care less expensive.

We’re not going to hit a sustainable anarchotopian equilibrium in my lifetime — the social changes required are just too great.  I do however think it’s worth it to try, and that we’ll approach anarchocapitalism in the limit.

I was planning to quote from an Ezra Klein article, but I ended up fisking it and doubling tripling my word count.  Here’s the haterade.

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