Another Leftish Howler on Government Health Care

From Kevin Drum, who I consider one of the smarter folks on the left (but not this time):

A few days ago, during an email exchange with a
friend, I mentioned that I don't usually tout cost savings as a big
argument in favor of universal healthcare. It's true that a national
healthcare plan would almost certainly save money compared to our
current Rube Goldberg system, but I suspect the savings would be
modest. Rather, the real advantages of national healthcare are related
to things like access (getting everyone covered), efficiency (cutting down on useless -- or even deliberately counterproductive -- administrative bureaucracies), choice
(allowing people to choose and keep a family doctor instead of being
jerked around everytime their employer decides to switch health
providers), and social justice (providing decent, hassle-free healthcare for the poor).

Name one industry the government has taken over in a monopolistic fashion and subsequently increased efficiency or individual choice?  Anyone?  Buehler?  In fact, I am not sure I can name one government program that even provides the poor with decent, hassle-free services. 

Lets take the most ubiquitous government monopoly, that on K-12 education. 

  • Efficiency?  My kid's for-profit secular private school has a administrator to student ratio of at least 1:15.  How many assistant principals does your public school have?  Many public schools are approaching 1 administrator for every 1 teacher.
  • Choice?  That's a laugh.  The government and its unions fight choice in education tooth and nail.  In fact, in the context of education, Drum and others have effectively argued that choice is the enemy of his last point, social justice, so it is absurd to argue that government monopolistic health care will optimize both.  Yes, people may be frustrated their insurance company does not cover X procedure, but this will only get worse when the government is making the choices for us.  Oh, and by the way, about the evils of those employers running our health plans?  They do so only because of WWII wage controls and decades of federal tax policy that have provided them strong incentive to do so. 
  • Decent, hassle-free service?  Ask a concerned black family in an inner-city school how good their kid's government-provided education is.  In fact, I will bet that most inner city parents get healthcare of better quality today despite the admittedly Rube Goldberg system we have (courtesy of years of silly government interventions) than the quality of education they receive from the government education monopoly.  After all, most of them walk out of the hospital today with their life, while many of their kids are walking out of worthless government schools with no life.

As to the claim that national health care would "almost certainly save money," that is hard to argue with for this reason:  The government, once in charge of health care choices, can simply start denying procedures and care ("rationing").  This is in fact how costs are managed in most socialist medical systems.  So while this statement is technically true, it would be very hard for anyone to really believe that for the same quality and quantity of care, the government could do it cheaper.


  1. James Howe:

    Supporters of national health care seem to have an enormous blind spot to the negative consequences of having the government (taxpayers) pay the bill. The simple fact is that when the Federal government starts paying the bills, health care will become even more politicized than it already is. It won't be long before various 'health' taxes or controls will be put in place in an attempt to get us all to live a healthier life style to help keep costs down. If people think birth control and abortion issues are contentious now, wait until the government takes over. Health care battles will rage over all sorts of medical procedures sides fight to cover/not cover aspects of health care that they deem important/wrong. Efficiency will occur in much the same way that Mussolini made the trains run on time.

  2. Jay Jardine:

    A howler indeed. As a Canadian who can't remember the last time he had his own family doctor (unless you have "connections", you have to hunt around for the least congested walk-in clinic and wait with the herd) I'd just like to point out how awful it is to watch this Health Care New Deal unfold south of the border.

  3. Mesa EconoGuy:

    Kevin Drum is one of the most economically ignorant people on the planet.

    This is simply a stupid statement:

    “It's true that a national healthcare plan would almost certainly save money compared to our current Rube Goldberg system…”

    No, it’s not.

    Our health care system devolved to our current state because of increased government interference after WWII. This interference has resulted in 1) increased inefficiency, 2) increased costs, and 3) increased Rube-Goldbergness.

    Kevin Drum’s answer is more of what caused the original problem. This will result in even more of 1, 2, and 3.

    Additionally, increased government interference (price fixing and “negotiation”) would likely result in massive reduction in new products:

    Who is this Kevin Drum moron? And why does he have a job?

  4. march:

    Socializing health care will kill people just as socialized schools leave us more ignorant. Only the rich will be able to get decent health care, outside the national system, of course.

  5. April:

    [Troll, sorry. Can't help feeling sarcastic.] Talk about how socializing health care will kill people...Look at the runaway deathly impact of our socialized military (free education, housing, job training, guaranteed employment, health care, etc.) compared to the corruption-free effectiveness of the privatized mercenaries we fund in Iraq to the tune of only part of nearly $1billion per day. I'll take a single source Halliburton-type contract before universal health care any day. Or give me a nice Neil Bush-type NCLB government education curriculum contract. The Cunningham business model thoughtfully applied to health care might solve our problems, I'd guess. Nothing Enron-style accounting wouldn't solve.

    We need higher health care costs increasing at higher rates to create incentives for hospitals to deliver better service. Free enterprise says all we need to know. No more regs. No more oversight or other delays to efficiency. Accountability is a liberal plot. Fire all non-loyal US attorneys (those who don't understand their political Republican responsibilities in our unitary executive system) and torture our enemies. A war against terror justifies desperate measures, and health care issues, relatively speaking, are non-issues; best ignored.

  6. tribal elder:

    We are fortunate to have a single nationalized industry to serve as the model for national health care - the US Postal Service.

    Back when Mrs. Clinton sought to be our health czar, I was thinking, while I waited in a long line at the post office, what the US Nat'l Health Service would look like. I envisioned a long, winding line of my fellow citizens, in hospital gowns (some with ties missing) and those horrid paper slippers, each holding a specimen cup in their right hand and paperwork in their left, while clerks hired away from the Department of Motor Vehicles gave instructions in something that sounded like English, sort of. At the head of the line was an electric sign, reading "Wait here for next available doctor" and which would flash window numbers.

    I suspect the signs are already in some government warehouse. They're probably bilingual.

  7. Steve:

    The 1:15 ratio at your child's school is administrator:teacher, not administrator:student, right?

  8. Dan:

    Back when I was in 5th grade, I had a classmate who wore a sweatshirt depicting a long line of people waiting in front of a hospital. It said, "Like waiting at the post office? You'll love socialized health care!" I had no idea what it meant at the time. I kind of doubt he did either.

  9. markm:

    What Steve said. I think the public schools I went to (class of '71) had a teacher to administrator ratio around 10:1, if you counted the "counselors" as administrators. AFAIK, colleges didn't have degree programs for school administrators through most of that period; the administrators were promoted from the best teachers, with very able secretaries doing most of the detail work so the principals, etc., spent most of their time on what they were definitely good at - dealing with kids and mentoring teachers.

    (One cost of women's lib is you don't often get such good secretaries anymore; a woman with that kind of ability should be aiming to be the boss, not the boss's secretary.)

    Your private school must do a fraction of the paperwork a public school does, nowadays. The paperwork burden on public schools has multiplied amazingly - which is pretty normal for government agencies. I spent 11 years as a military serviceman and in defense contracting, and always, it was more important to have the paperwork right than actually to get something working. E.g., there was a flight simulator facility which hadn't been operational in a decade, but had passed every inspection with top marks - the paperwork showing why the thing couldn't be fixed was perfect! The military's slide into bureaucratic uselessness is periodically reversed by a war in which those that don't get something besides paperwork done are likely to die. Businesses can also fall into the paperwork trap, but then a more efficient competitor will destroy them. Other government agencies have no such limitations on how bad they can get - and when the politicians finally notice that they have become ineffective, the "solution" is usually more money for more bureaucrats, and to hope that somewhere in there will be someone that actually tries to advance the mission.