Thursday, April 25, 2013

Freedom to overpay for healthcare

By Frank Moraes

Back during the end of the Bush administration, Andrew Sullivan and Ezra Klein got into a bit of a pissing contest and I think it bears discussion. Klein wrote an article where he praised (at least) the efficiency of the United Kingdom's actual socialized medical system (the doctors work for the government). I'm sorry to say that I haven't been able to find the link to it because neither Klein nor Sullivan linked to the original article. It doesn't really matter.

Sullivan, who is originally from the UK, shot back, "One reason I'm a conservative is the British National Health Service. Until you have lived under socialism, it sounds like a great idea." He goes on to note that it isn't that bad. But, "I prefer freedom and the market to rationalism and the collective. That's why I live here." That doesn't sound so bad. It's a typical argument that you hear in favor of the broken American healthcare system. But wait.

Sullivan had been the wunderkind editor of The New Republic (where he more or less destroyed the reputation of a once great magazine). And then after that, he was a much in demand writer. In other words, he was making a lot of money. So of course he would love the system here. In fact, if he were in the United Kingdom, I'm sure he would love the private medicine he could purchase there. This is the Dick Cheney Effect: rich people get great healthcare wherever they are.

The question is not ever, "What is the best healthcare system for people with loads of money?" We don't decide that the best approach to car insurance is to have every driver put a cool million in a bank account against the threat of accident. Why not? That's a great idea for the rich. But it doesn't work for the rest of us. And that is a big part of the problem with income inequality. As economies become more unequal, the rich become more powerful and the government attends more and more to the needs of the one part of the society that doesn't need taking care of: the rich.

What exactly is Sullivan's point? It is the same as every fool who says, "America has the best healthcare system in the world!" What they mean is that you can get the best healthcare here if you are able to pay for it. And that is pretty much true in any country you can name. For the rest of us, it isn't that way. And Klein demolishes Sullivan on that point. He presents surveys of actual healthcare users and finds that people with socialized medicine and insurance like their systems far more than Americans like their supposed freedom.

Sullivan can love the "freedom" to pay twice as much for his healthcare as the rest of the advanced world. But the rest of us would like a system that actually works.

(Cross-posted at Frankly Curious.)


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