health care, flip-flopping, and drunken boxing…er…blogging
Okay, so Michael Drew in the comments has pointed out that I have been inconsistent in my take on health care. Indeed, my take on health care is one that is “in the making” as it were, and so this is not surprising. I have moved, and rather quickly (I admit) from support of a public option to not supporting a public option, though nothing is set in stone. The more I have studied this, the more I have come to believe that the public option would become as much of a distortion as the system we have now.
At the same time, my first concern remains insuring the uninsured. I think what I was driving at in my initial “multi-tiered” approach was an attempt to have freer markets, thus maintaining our high level of quality and innovation (and probably improving it on both those fronts) while at the same time ensuring that everyone is insured via the public option. If all else fails – and I’m sure it will – then I will still be glad that people who are not insured will be once a public option is in place. If that actually happens. I think that when we break this down to a very human level, it’s important to realize that at the heart of it all is a very real, very devastating problem for many Americans.
My turn toward vouchers rather than a public plan comes essentially from some very convincing arguments brother Mark has leveled at me – namely that there are two ways a government can dole out subsidies – either to the supply side or to the demand side. Subsidizing supply effectively picks “favorites” in a given industry (say drug companies, for instance) whereas subsidizing demand does not. It spreads out the subsidy and allows for various groups to compete. So you still have government helping people get insurance, you just don’t have them subsidizing specific groups to do it. Since I’m an avowed anti-corporatist, this appeals to me a great deal. I don’t like public/private collusion. As government grows, so do powerful corporate interests. See A.I.G. or G.M – neither would have survived without welfare.
The way our system works, even “public” options end up involving a great deal of private entities. So you have a public plan, and the government is able to buy drugs in bulk driving down their cost. This, we are told, will help keep costs lower than they are now. However, you have to take into account the powerful drug-industry lobbying groups. The whole notion of government buying in bulk will lead to big companies who can supply this quantity of drugs cheaply. Pretty soon lots of smaller companies are forced out in favor of these big, cheap drug companies. Indeed, lots of generic alternatives are forced out because these big companies have such powerful lobbying arms. And then the price of those cheap drugs slowly starts to drift back up, because guess what? Competition has fizzled out. Monopoly has been created.
Something like this already takes place in our much-twisted system. I’m not convinced a public option would make things any better, or that it would act as I first supposed, as a competitive force against which we could pit the weight of the free market. Maybe I’m wrong. Maybe that would be exactly how it would work. If in the end we can say that the public option saved some people’s lives, saved families from bankruptcy, saved some sick kids – then great. I’m all for these things. I just want to do it in a way that helps people attain quality health care, and I’m not at all convinced that the government’s plan is going to be the best way to do that.
I’m also a supporter of the progressive income tax, but I think at some point people will need to start footing a larger portion of the bill all across the board, especially if all these big entitlement plans are pushed through. There’s going to be an increase in taxes all the way down, because it’s the only reliable way to net enough revenue to pay for everything. Wonky liberals like Yglesias are saying the same thing.
So just as I think conservatives are like broken records with their unceasing calls to lower taxes, I think liberals need to really evaluate what across-the-board tax hikes mean for our economy. I think this massive deficit needs to be scrutinized and looked at with a degree of trepidation by liberals and conservatives alike – just like the foolhardy wars of the Bush administration and the budget-gone-wild policies we were subjected to the last eight years should have been met with more scrutiny from both sides of the aisle.
I’m not a partisan. I’m persuadable. If people can convince me of something, I’ll change my mind. I like ideas. I like my ideas being challenged. I blog aloud, as it were. I may have ten changes of mind in ten different posts on a subject, but I rarely have a change of heart. So I don’t view flip-flopping as a bad thing unless it’s self-serving and disingenuous. My own flip-flopping is almost entirely in regards to means, not ends. I’m a means-oriented conservative in many senses. My goal in the health care debate is to get everyone covered. I think health care is a right. And even if it’s not, then it’s an essential piece of a stable, prosperous society. We should not have people going into bankruptcy because they get sick. We should not have children without health care.
And maybe I’m wrong. Maybe the government will be able to provide for all and do it well with a public plan. History doesn’t really bear this out, though certainly I’m grateful we have a safety net now in the form of Medicare. We are better off with that than with nothing at all, and no matter how conservative the policies I’ve suggested are, at the root of them is still the belief in strong safety nets.
But the public plan…? Socialized health care….?
Oh sure, lots of other countries do it well. One hears this in the comments a lot. And I love some systems out there – especially the German system. Boy, if we could do that in the States I’d be all for it. It’s just not how our system works though. We have a less elegant form of government here, and that’s not changing anytime soon. The United States is simply not other countries. We are what we are and we have to work with that in mind.
So bear with me. I realize that you can draw up quotes from past posts that directly contradict more recent ones. I am always open to new ideas and to argument and to good, fierce, healthy debate.
Oh, and here’s the House plan…