Searching for a Solution’s Problem

John Cole writes about the direction of health care in America (in response to an entry by Andrew Sullivan).

… Only a fool can not see the writing on the wall- we are going to have to move to single-payer at some point, because businesses can not compete and the largest problem for Detroit is… their health care obligations and other retiree benefits. Likewise, we spend an enormous amount of our GDP on health care yet have rankings that look third world on issues like infant mortality. Something has to give.

I don’t want to play the fool here, because I see that we’re moving to single-payer at some point. That’s the obvious political outcome driven by our unthinking, economically-illiterate public debate. This is a Bad Idea because of the problems everyone is glossing over, particularly those involving rationing.

But that’s not my quibble here. We do not have to move to single-payer. If part of the problem for American business is the cost of health care, the proper step is to separate health care from employment. Single-payer is one route to attempt that, but it is not the only route.

Do we have a national automobile insurance crisis because our employers do not provide subsidized auto insurance? The comparison is weak, as I’m happy to admit. The absurdity is intentional. But it points out that options exist beyond Employer or Government. The incentive system involved in employer-provided health insurance is flawed. We need to move beyond our limited mindset that if someone doesn’t take care of us, we’re all going to die a horrible, uninsured death.

Mr. Cole is more cautious about the possibility of success from that outcome than most, but he uses emotional justifications to support the national undertaking. For example, infant mortality is more complex than just reciting statistics. As the link shows, there are ways to look at the complexities that don’t prove that U.S. infant mortality rates are meaningless as a comparison. But this issue is too big and the outcomes too loaded with consequences to disregard the nuances and uncertainty in favor of a pre-determined solution.