Megan McArdle At Bloomberg: ‘Simple Policies Win Elections’

Ron Fournier at the National Journal: ‘Obamacare’s Foundation Of Lies

On the Gruber gaffes (forcing healthy people to work against their interests with knowing lies withheld by a chief Obamacare architect in order to get the thing passed):

‘A lie is apolitical, or at least it should be. If there is one thing that unites clear-headed Americans, it’s a belief that our leaders must be transparent and honest.

And yet, there seem to be two types of lies in our political discourse: Those that hurt “my party” and “my policies”; and those that don’t. We condemn the former and forgive the latter—cheapening the bond of trust that enables a society to progress.’

Megan McArdle has a piece here.

Aside from the Gruber gaffes:

‘So too, with Obamacare.  They wanted a massive overhaul of the whole system, but they couldn’t do that cleanly, so they jammed a bunch of complicated mechanisms into one sort-of-working bill.  You may like the goal of Obamacare, or you may not. Either way, you probably wouldn’t choose this particular method of implementation, which is simultaneously less comprehensive, more expensive and more annoying than many other methods they could have chosen.’

You don’t have to be libertarian to find some of Richard Epstein’s suggestions…reasonable:

As I have noted before, there is only one type of reform that can make progress in meeting the three goals of a sensible health care system: cost reduction, quality improvements, and public access. That reform requires massive deregulation of the many market impediments that are already in place. Lower the costs, drop the excessive mandates, and thin out administrative costs, and people will flock back to the system voluntarily.’

I still see a massive, top-down, poorly conceived law that freezes a lot of the problems in place, adds more layers of bureaucracy on top, and serves a narrower range of interests that claim universal, utopian ideals.

Follow the money.

In the meantime, the rising costs, bloated bureaucracy, misplaced incentives etc. of the current system continue.

First, do no harm.

Related On This SiteFrom The New England Journal Of Medicine Via CATO: ‘The Constitutionality of the Individual Mandate’From If-Then Knots: Health Care Is Not A Right…But Then Neither Is Property?… From The New Yorker: Atul Gawande On Health Care-”The Cost Conundrum”Sally Pipes At Forbes: ‘A Plan That Leads Health Care To Nowhere’From AEI: ‘Study: ‘Obama Healthcare Reform Raising Costs, Forcing Workers Out Of Existing Plans’

A Few Health Care Links-03/18/2010

From Keith Hennessey, Understanding The New Health Care Reconciliation Bill.  A good site to get caught up.

Megan McArdle sounds dejected: First Thoughts On The CBO Score.  Some interesting comments.

Paul Krugman back in 2006 at the NYT:  The Health-Care Crisis And What To Do About It.  Krugman offers his vision of what to do to contain rising costs due to vast inefficiencies, and what has caused the inefficiencies:

“First is the increasingly rapid unraveling of employer- based health insurance. Second is the plight of Medicaid, an increasingly crucial program that is under both fiscal and political attack. Third is the long-term problem of the federal government’s solvency, which is, as we’ll explain, largely a problem of health care costs.”

Of course, “free market ideology” and politics are getting in the way of what Krugman argues is the only effective solution:  these separate problems need comprehensive reform, and the government is the only entity capable of delivering it.

Of course, we’ll still have poor people without much/any access, a need for rationing (never enough money, always too much need), waste, inefficient spending due to self-interest etc as well as what I think Krugman underestimates as the potential for simple corruption, government inefficiency, and the dangers of tying political interests to so much money and human need (the innovation that will be lost).  He doesn’t spend much time discussing the downsides.

But, where is there a counter-vision by a fiscal conservative?

Link:  Reihan Salam at Bloggingheads states it simply:  Forget all this compromise talk and smoke and mirrors.  The left is this close to winning a philosophical victory, and this is the first step toward what the progressive left really wants, which is government controlled health-care.

Update:  A reader sent this link to the Heritage Foundation.  It’s a start.  If you have other links, fell free to send them in.

Also On This Site:  From Youtube Via Althouse-’Paul Ryan: Hiding Spending Doesn’t Reduce Spending’

The most knowledgable articles I’ve read that make the case for some government involvement are here:

Atul Gawande At The New Yorker: ‘The Cost Conundrum Persists’

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Health Care Reform-A Few Links 01/05/10

Keith Hennessey is following the bill closely.

Bloggingheads with a libertarian (Megan McArdle claims against the odds that the health care bill could be dead) here.

Who will enforce the new health insurance requirements…the IRS?  Reason has more here. (Private insurers are protecting their interests).

James Surowiecki at the New Yorker asks the question why do we need private health insurers in the first place?  Full post here.

Well, to more effectively control costs and manage risk (especially as regards fraud)…I’d say yes.

On This Site:  The political system is, in my opinion, neither the best nor most efficient way of addressing the jerry-rigged health-care delivery system we have…and its rapidly rising costs.  Atul Gawande, however, makes a decent, evolving, pragmatic case for some government involvement:

Atul Gawande At The New Yorker: ‘Testing, Testing’From The New Yorker: Atul Gawande On Health Care-”The Cost Conundrum”

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From Reason’s Hit And Run Blog: Obama And The Mayo Clinic

Full post here.

Atul Gawande has a New Yorker piece, in which he suggets the Mayo Clinic might be a good model to begin addressing health-care costs and doctor incentives.  The Obama administration cited the Mayo Clinic too, as a model, but the Clinic isn’t too impressed with the bill:

“In general, the proposals under discussion are not patient focused or results oriented. Lawmakers have failed to use a fundamental lever – a change in Medicare payment policy – to help drive necessary improvements in American health care.”

Ouch.

Early June summary of the bill on Keith Hennessy’s site, specifics here.

See Also:  From The New Yorker: Atul Gawande On Health Care-”The Cost Conundrum”  From Clive Crook: Is Health Care Reform On Track?

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