We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
Obama has demonized just about every business sector in America. Through the 2008 campaign to the present, he has gone after credit card companies, the coal industry, mortgage companies, real estate companies, steelmakers, utilities, drug companies, doctors, oil companies, Wall Street, defense contractors, and health insurance companies, just to name a few. In each case he has dinged them for greed, taking excessive profits, and failing to put people first. His criticisms have not been over minor matters but over their basic core functions, and their values or lack of them. [His demonization of talk radio and Fox News also constitutes a front in his attack on business -- Ed]
Obama demonstrates almost complete ignorance about the private sector and it’s no wonder: he has so little experience in it.
The promise of the public plan is a mirage. Its political brilliance is to use free-market rhetoric (more "choice" and "competition") to expand government power. But why would a plan tied to Medicare control health spending, when Medicare hasn't? From 1970 to 2007, Medicare spending per beneficiary rose 9.2 percent annually compared to the 10.4 percent of private insurers -- and the small difference partly reflects cost shifting. Congress periodically improves Medicare benefits, and there's a limit to how much squeezing reimbursement rates can check costs. Doctors and hospitals already complain that low payments limit services or discourage physicians from taking Medicare patients.
I read Mr. Samuelson's article and agree with most of it. We continue to miss a few important points that do separate health care from other consumer goods and services.
1) When you need health care, there is usually no good substitute. You can take a bus or buy a car. Maybe you don't have to go where you want to go and skip the whole trip. When your appendix has to come out, it has to come out. When your child has pneumonia, your child needs treatment.
2) Healthcare is often time sensitive. With appendicitis and pneumonia, you need treatment quickly. You don't have time to save up for it.
3) Health care spending may have limits but health care needs may not. Care for appendicitis and pneumonia is limited in scope and expense. Care for cancer or diabetes or end-stage renal disease may go on for months or years. Your insurance benefit may run out while your disease process is still going on.
Mr. Samuelson's points are valid even in the teeth of how healthcare needs are genuinely different from many other economic needs. The differences help explain why the debate is different, though, and why the answers are elusive. When my life, or my ability to function, are at stake, I'm ready to spend a lot of your money.
However, all of this begs the question. What is the role of government and where is the constitutional authority for government health care (and many other federal programs)?
This is the true debate in my mind. Let's not get distracted and pulled into a debate about "how much" government health care should there be. We already have enough in the bankrupt Medicare program, which I would argue is also unconstitutional.
Universal heath care is a states issue if it belongs anywhere.