Wednesday, August 19, 2009

It's about power, stupid

The truly strange thing about the war over the "public option" is that it is probably the most market oriented facet of the whole health care reform package. The wrong guys support it, the wrong guys are opposed.

Normally, the left would simply resort to regulation: "Though shalt not charge more than..." and screw up the economics of health care more than they are screwed up.

"At a minimum, there should be very strict regulation of all insurers, on and off the exchange, to promote competition and fair prices and substantial subsidies to help low-income people buy insurance..." editorializes the New York Times, again illustrating how the left doesn't "get" economics. To promote competition you don't regulate insurers, you guard the markets, reduce "barriers to entry," etc.

There are many market forces in place that drive up the cost of health care "as a system." Doctor owned diagnostic centers, for example; lack of competition in any one geographical market; insurance oligopolies; no standardized charting.

The antidote is to introduce forces that can systemically drive down prices, and that is best achieved through competition. That competition is best enhanced with public options, consumer choice, consumer consequences, all of which are lacking in the current environment.

And maybe for that reason alone, the brains of the Republican right are so opposed. The public option might actually work, because it really is a market-based tool. A tool they should favor.

On the other hand, if they can kill the public option and force the left into its comfortable role of law-based decision making, they will be able to point out that the left does want to deny choice, favors government over the individual. It is a long term strategy to get back into power.

The administration needs to grab this process. It can not be left to the right, nor the blue dogs, nor the far left. This administration is in a unique position to take all the good ideas and rework the health care landscape, with or without "compromise." Their plan could be the compromise.

There are many good ideas out there. Public option. Co-operatives. Tort reform. Transportability. Elimination of rules that limit plans to "in-state." Standardized, transferable electronic records. Perhaps they all need to be given a chance.

It is time to get to work.


Anonymous said...

The problem with this whole mess is that Obama is proving not to be a leader, but one who is led.

Anonymous said...

Agree with Anonymous #1.

The administration has been incoherent and incompetent and failed to lead. Thus you have talk radio framing and driving the "discussion".

You can blame the right all you want for preferring to hand Obama a defeat rather than actually solving problems, but the administration should have been prepared for that and had a plan in place to counter it — or better yet, get ahead of it.

If health care reform fails in this, it's best shot, it's on Obama.