What the U S A as the World's Oldest and Most Successful Democracy Can Learn From Others~~ HOW TO FIX HEALTHCARE~~

What do the world's "laboratories of democracy" tell us about health care?


AnonymousLiberal blogger eloquently reasons:

Republicans, at least rhetorically, claim to value federalism and to believe that the states can function as "laboratories of democracy"-- places where policy experimentation can take place. Through this process, flawed policies are exposed and voted down and newer, better policies are given a chance to prove themselves. Over time, the policies that prove to be the best are adopted by other states.

For some reason, though, the only laboratories of democracy that matter to Republicans are those located within the United States.

This is especially true when it comes to health care. The United States is not the only industrialized democracy in the world. We are, however, the only one that does not guarantee basic health care to all of its citizens. When Democrats propose relatively mild reforms to our current dysfunctional system, such as creating a public insurance option, Republicans flip out and suggest that doing so will result in some sort of socialized health care dystopia.

But we don't need to travel into some hypothetical world to understand what universal health care looks like. There are literally dozens of countries in the real world that have functioning universal health care systems. Indeed, the verdict of the world's laboratories of democracy is pretty clear. Virtually all of them produce better health outcomes at less cost while covering everyone. We're the outliers. We're the laboratory that's stubbornly refusing to acknowledge that its experiment has failed.

To adopt the Republican position on health care requires believing that every other country in the world is wrong, that their policy experts are misguided and their citizens confused. Indeed it requires believing that the American people themselves are wrong, that despite endless opinion polls to the contrary, people in this country really love the system we have.

You would think that, at some point, these lovers of federalism would ask themselves why it is that no country in the world currently has (or has any plans to adopt) the kind of health care system they're clamoring for. After all, if the ideal health care system is one in which the government plays the least active role and lets the free market work its magic, you would think that some country would have already tried that by now. Such a policy is, after all, much easier to execute and to fund. It's infinitely less complex and requires much less government spending, so you would think that at least some group of lawmakers somewhere would have given the "do nothing" approach a shot. And if the results were as great as the Republicans claim, by now most countries would be following such a system.

Of course, the reason no one follows such a system is because it doesn't work. As economists have understood for many decades, markets don't work very well in the area of health care, at least if the goal is producing a world in which most people can afford care. Indeed, the reason we have a patchwork system of health care in this country is precisely because the market doesn't work and the government has been forced to step in and remedy its most glaring failures. Under a free market system, most elderly people are priced out of the market (hence the need for Medicare). Under a free market system, the poor can't afford health care (hence the need for Medicaid). Under a free market system, children of those without insurance have no access to health care (hence the need for S-CHIP). Every health insurance regulation or government program currently on the books was passed in order to address a significant failure of the market.

Other countries have confronted the exact same issues, but instead of trying to solve these problems piecemeal, they have opted for a comprehensive approach. In an effort to discredit the far better approaches taken by other countries, Republicans like to cherry-pick stories of people who were denied treatment or had to wait for treatment under a universal system (while ignoring the very same kinds of stories in our country). But here are some numbers they ignore:

The number of people in other industrialized democracies who go bankrupt as a result of medical bills = 0

The number of people in other industrialized democracies who lack access to routine medical care = 0

The number of people in other industrialized democracies who feel trapped at their jobs for fear of losing their (or their family's) health insurance = 0.

That last number is particularly galling given conservative reverence for entrepreneurism. Though it's difficult to quantify, I would bet that our dysfunctional health care system, more than any other factor, discourages entrepreneurial risk-taking in this country. Which makes all this talk about free markets all the more absurd.

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Anonymous Liberal's Got It ! Right

Bipartisanship on Health Care Makes No Sense

Whenever I hear someone call for a "bipartisan solution" to the health care crisis in America, I just want to pull my hair out. It makes absolutely no sense whatsoever. It's like calling for a bipartisan solution to the next presidential election.

Health care policy is a definitional issue in American politics. For as long as I can remember, the Democratic party has fought to increase the government's role in providing health care coverage for Americans while the Republican party has fought to reduce the government's role. The Democrats are responsible for Medicare, Medicaid, and S-CHIP; the Republicans fought all of those initiatives. On a policy level, the Democrats believe that the best health and cost outcomes can be achieved by increasing access and encouraging widespread use of routine and preventative medical care. Republicans, on the other hand, have routinely identified the problem as over-consumption of care. Their proposals to fix the system inevitably involve significant deregulation with the goal of encouraging the use of high-deductible policies to try to discourage personal consumption of health care. Nearly every Democrat (including the blue dogs and "centrists") believes this to be bad policy.

In other words, there is virtually no common ground between the parties. The parties don't even see eye-to-eye regarding basic goals and policy assumptions. So why on earth would anyone believe that there is a bipartisan solution to health care? If one side believes the answer is behind door #1 and the other believes it is behind door #2, the correct answer is never to walk into the wall between the doors. Yet any conceivable "bipartisan solution" to health care would amount to exactly that.

Furthermore, as a simple political matter, it makes no sense to seek Republican support. First, it's a quixotic quest. Putting aside the fact that the Republicans are determined to uniformly oppose any significant Obama initiative, on this particular issue, there are actual principles and core beliefs underlying that opposition. Yes, there is a lot of standard Republican propaganda and demagoguery as well, but beneath all that disinformation is an actual philosophical disagreement. I happen to think that Republicans are dead wrong about health care, but I don't question that their beliefs are genuinely-held.

At the end of the day, no matter how willing the Democrats are to water down their proposal, they are unlikely to get any Republican support. And even if they were able to woo a few Republicans, it would not provide any meaningful political cover. The Democrats would still own the final bill.

Which is fine, because there is virtually no political downside here. The Democratic party is already identified with the issue of health care. It's one of its chief strengths. Despite their reluctance to support anything progressive, the reason red state Democrats like Ben Nelson get elected at all is because of issues like health care, where most people side with the Democrats. And it's not like what's on the table now is particularly radical. We're talking about providing people with a choice, giving them a public health insurance option if they want it. Not only is that idea already wildly popular, but it has virtually no political downside. Republicans and the insurance industry will do their best to demonize such a policy, but at the end of the day, no one is going to be upset that they are being presented with more options, and many people will be immensely thankful for it. Once the dust clears and the bill is passed, there is almost no political risk.

So the goal here should not be bipartisanship. The goal should be come up with the policy that is most likely to be effective and then browbeat every last Democrat in the Senate until they're on board. I don't say that about every issue, but on this one, there is no other sensible option.

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What Planet are They From

Dispatches from the Alternative Right Wing Universe

Anonymous Liberal wrote a few days ago:

John Hinderaker at Powerline recently wrote the following about Barack Obama:

Everyone knows that Barack Obama is lost without his teleprompter, but his latest blunder, courtesy of the Milwaukee Journal Sentinel, via the Corner, suggests that the teleprompter may not be enough unless it includes phonetic spellings. [Obama apparently mispronounced the name of the company "Orion"]

So evidently we have to add astronomy to history and economics as subjects of which Obama is remarkably ignorant. I'm beginning to fear that our President has below-average knowledge of the world. Not for a President, but for a middle-aged American.

If that alone isn't enough to make your head explode, here's what the very same John Hinderaker had to say about our previous president:

It must be very strange to be President Bush. A man of extraordinary vision and brilliance approaching to genius, he can't get anyone to notice. He is like a great painter or musician who is ahead of his time, and who unveils one masterpiece after another to a reception that, when not bored, is hostile.

The alternative universe that these folks manage to create for themselves is really quite something to behold. In their world, a man who was the editor-in-chief of the Harvard Law Review and a constitutional law professor at a top law school is some sort of empty suit who is incapable of thinking or expressing a coherent thought without a teleprompter. A man who spent much of his childhood in Indonesia, has travelled extensively overseas, and who, by all accounts, is an avid student of foreign policy is some kind of ignoramus who knows nothing about the world.

But a man who was notorious for his struggles with the English language, who achieved everything in his life by virtue of his last name, a man who admittedly had no interest in foreign policy and had traveled nowhere prior to becoming president . . . that guy is worldly beyond measure, a "man of extraordinary vision and brilliance approaching to genius."

What's really sad is that Hinderaker is not alone in this belief. If you read the right wing blogs, it's just an accepted fact that Obama is a moron. It's as if they think that if they say it over and over again, it will somehow catch on with the public at large. The problem with this meme, of course, is that it's so easily disproven. No one who watched Obama give his hour long prime time press conference last month--where he gave lengthy professorial answers to every question asked--would entertain for even a moment the suggestion that he is stupid or unknowledgeable or incapable of speaking without a teleprompter. The right wing blogosphere might as well be trying to convince the public that Obama is white.

But in the up-is-down world of the right wing echo chamber, anything goes, no matter how dumb.

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