Quotes of the day

the Republicans had plenty of chances to take ownership of the health care issue and pass a significant reform along more free-market, cost-effective lines. They didn’t. The system deteriorated on their watch instead. And now they’re suffering the consequences.”

I am going to be blunt–though I by no means consider myself a wonk on this issue, I really question the entire reform thing. Sure, the often-cited proposal to allow insurance companies to compete across state lines makes sense. But at the end of the day, if you are talking about making healthcare more “affordable”, then I can’t see how what you are talking about isn’t basically going to boil down to forcing a lot of talented, highly educated people who have to spend a lot of years in school studying–doctors, biomedical engineers, chemists, etc.–to accept something on the order of $50-70,000 a year (max, with less for those further down on the training pole–EMTs, nurses, etc.) in order to make healthcare more “affordable”. In other words, we want to make education not pay. And that is exactly what will happen–it won’t pay. And so people won’t pursue that education. Or won’t eventually stop using it.

Because I posit that health care is expensive not because of greed, but because a lot of the cost goes into compensation for people who have to spend a lot of time gaining the skills needed to make healthcare possible; and I also posit that the only way to cut costs is to eventually cut that compensation. Period.

My gut instinct here is to say that the realistic solution is to accept that healthcare is always going to be expensive, and to work diligently to grow the economy so that ever-increasing levels of wealth reduce the relative level of income paid for it. That is a long term solution not palatable to the left, of course, but I think it is the real one. And the only one. Grow the economy. Long term, most people will have the resources needed to obtain the healthcare they need, and those that don’t will be but an inconsequential drain on the economy (and government coffers). And, as a personal aside, only if it is a small number, and an inconsequential drain, do I support widespread public financing of healthcare for the able bodied. Sorry, not trying to be Scrooge here, but there is such a thing as incentives. Perverse ones, even.

At any rate, the fact is that what the left wants to do is just not achievable with the current population as sized to the current economy. We have to grow the economy to provide what is wanted, and that is reality. Pointing to Europe as a way of saying “no, it can be done” will get you no points from me–because as Mark Steyn has pointed out, Europe’s long term ability to maintain a Western culture and a welfare society would seem to be in doubt. So, if that is your argument, I reply that we need to check back in another 30 years and see how it is going, because I think that may be real length of their epicycle. About 70-90 years total. With no guarantees it will play out well.

Or in other other words, everyone seems to have momentarily forgot that we still don’t know how to fund Social Security in about 10 years…fund it, and not destroy future growth, that is (as well as the human spirit that says “I shall be the main beneficiary of my talents”).

So I’ll summarize this in terms people can understand–when a young couple starts out, they can probably only afford an apartment. Later, maybe they can buy a house and afford the kids. With hard work and a good career path, later come the family vacations and college educations (while still paying for the house). Even later–with careful attention to one’s career and earning power—comes the vacation home and the investments and the luxury cars. And so on.

A nation is the exact same way–the left right now want to send the kids to private schools and have expensive tutoring lessons, when you know what? We can’t afford it, we can only afford public schools, and that is simply going to have to be good enough.

We as a nation are going to have to learn that something can be good and not doable (or prudent) at the same time. I can name you about five things that would be very desirable for me to do right now, each one a positive benefit to my future plans. But I can’t do them, because it would destroy the future plan, because I can’t afford them. So it is with healthcare.

And we are not going to be able to just tax our way to a solution. It is time for liberals to accept that as payment for the bounty of capitalism that allows many to live well, some people get to get rich. And it might not even be the people that “should” get rich. But that is just the way it is. For human nature does not allow for any of the options they envisage. Deny human nature, penalize those who are able to do well, and you will get, eventually, nothing. For people hate injustice, and they have a strong evolutionary instinct not to tolerate freeloaders. Mutual support is one thing. Freeriders are something else. I will not work harder so you can work less. So taxing higher and higher is not, has been proved to be not, the real solution.

So, I would say once again that forcing doctors who spend years as poor students, who can basically only afford to eat Ramen noodles until they are about 30, to accept less money while a union hack with a high school education sits on a well-preserved $80k/annum job is not a “good”. It is instead a perverse incentive, an injustice, a travesty, and one that will be noted, to everybody’s detriment. People have an instinctive feel for justice, and those who are bright are only going to accept so much “Harrison Bergeron” treatment before they just start packing it in. It’s human nature.

Or in other words, if you think your typical ACORN or SEIU goon could be your doctor, more power to you. But if you don’t–then why are you siding with them over those who can do the job? For at some point you have to render unto Caesar what art Caesar’s, God what art God’s (if you go that route), and those who can acutally do the job what art those who can actually do the job. And that “rendering” comes in the form of cold hard cash. Period. Or else those who have the talent will find something else to do, out of spite if nothing else.

And so, once again, how are costs going to be cut? Only by penalizing those whose main crime seems to be being talented enough to do what others can’t do.

And thus, I am not sure I agree with Mr. Douthat at all. But once again, there may be a reform I am not aware of.

Horatius on December 21, 2009 at 11:23 PM