Friday, December 18, 2009

30 million reasons.


In today's column, Brooks lists the reasons to support and oppose the healthcare bill currently under consideration in the Senate.

His reasons to oppose the bill anger me, each in its own unique weakly reasoned and misleading way. But the thing that bothers me the most is the opening sentence:

"The first reason to support the Senate health care bill is that it would provide insurance to 30 million more Americans."

Brooks spends exactly 21 words in his 800-word column on this fact as if to quickly get that out of the way so he can talk about the important stuff.

Well, here is my list:

1. It will expand health insurance to 30 million Americans.

2. It will be budget neutral .. and I don't care what Brooks says about the alleged political inconceivability of spending cuts. If you really believe that you can't support legislation because the Congress will never be able to stick to its targeted savings embedded in it, that's political nihilism and effectively invalidates any further debate. On the one hand he wants more cost control, on the other hand he doesn't believe that the cost cutting measures in place will be implemented. What exactly does that leave the Congress with then?

3. It will expand health insurance to 30 million Americans.

4. It will save tens if not hundreds of thousands of lives every year.

5. In case you missed it, it will expand health insurance to 30 million Americans.

6. It will launch a host of ideas to improve the system.

We're not talking about anything revolutionary or immediate here but I have absolutely no idea what else Brooks is looking for that would:

(a) improve quality and efficiency
(b) correct all the messed up incentives currently in place
(c) cut not just wasteful spending but also total spending (that seems to be what he is looking for in his reason to oppose # 2)
(d) and at the same time do all magic this BY MEANS OF A SINGLE BILL and AT THE SAME TIME not be achieved with some measure of government involvement in the current system (which he cites as reason #4 to oppose).

Brooks is opposing the bill because it fails to live up some vague ideal of "getting the fundamental incentives right" .. but he also expects us to believe that it's a tough call for him, and he "flip flops" every day, as if the bill kept changing dramatically overnight from one that fundamentally transforms the system to a bad one that only insures 30 million more people without bending the cost curve.

As if all this time it seemed like we might, in the end, suddenly, find the holy grail .. and - OMG, oops - we didn't, so - sorry 30 million uninsured Americans, better luck in 16 years!

And those 350,000 of you that die in the meantime because you have no coverage - you can rest in peace because .. we didn't slow innovation!

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