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Saturday, January 19, 2013

 
Life, liberty and health care

by digby

Dave Johnson has a nice piece today about this new Nate Silver analysis which shows that "health care entitlements" are the cause of government deficits and will eventually choke off growth. He points out that Silver is only looking at the numbers but worries that his credibility will lead people to conclude that we must, therefore, cut government spending on health care. And unlike most others, he points to the analytic process which leads to this problem: the "manager" effect, also known as technocratic governance.

[T]oo many people who are looking at the government’s budget problem from a background of being “managers” just don’t look at the bigger picture of what happens in the whole economy. They only see the problem of the government’s budgets and only think about how to fix that problem.

So if the problem is that health care costs are going up in the federal budget, a manager of the federal budget will want to fix that by cutting costs – providing less health care to people, and other things that lower the costs in that budget. They are not looking at the underlying causes. They are not going to look at what their solution does elsewhere. That’s not the problem they are looking at.

The bigger picture, of course, is that providing less health care only means people have to go elsewhere (or nowhere), which has terrible effects on the people — and ultimately on the economy. When people are hurt by this, that’s not the manager’s problem to solve. And when the economy is hurt government revenues are hurt, and budget deficits get worse — and that’s not the manager’s problem to solve, either.

A manager perspective means you only care about the problem in this one area, so they say we have to “reduce government spending” in the budget as you see it today, without understanding that only means shifting it onto the private sector, which just makes everything worse, including the long-term budget picture because of reduced future revenues. (And, again, hurts people.)

Now a slimy con man like Paul Ryan will say that the private market will solve all of this by making 82 year-olds shop for cheaper open heart surgery so we'll have the magic of competition to bring down costs. I think all but the most deluded ideologues know that's not going to work. So what we have left is plain and simple rationing unless the government makes a much bigger role in reining in health care costs.

And as Dave Says:

Fortunately, it looks like this rise in medical spending might be starting to get under control. The real answer for the bigger picture is, of course, Medicare-for-All.

And by the way, "health care entitlements" is a really loaded phrase. On it's face, it makes perfect sense. Yes, citizens of the wealthiest nation on earth should be "entitled" to health care, just as they should be "entitled" to food to eat or air to breathe. Unfortunately, the right has succeeded in making it a pejorative term that suggests these things are unearned or somehow unaffordable luxury items to which only those of means have a claim.

Health care falls into the category of being "entitled" to "life, liberty and the pursuit of happiness" and any suggestions that it's unaffordable is sheer nonsense. Of course it's affordable. Any nation in which you can go into a store and buy 50 different kinds of mascara and little schoolchildren have their own computers can afford to take care of its vulnerable and sick. It's a choice.

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