Code Red: Two Economists Examine the U.S. Healthcare System

September 21, 2009

Keep Your Eyes on the Prize

Filed under: Health Reform — David Dranove and Craig Garthwaite (from Oct 11, 2013) @ 5:57 pm

Last week, I had the privilege of speaking at the Tenth Congressional District Democrats Town Hall meeting on healthcare reform. I was quite literally the only Republican in the room; at least the tea party folks didn’t show up. But I am a weird sort of Republican. I am ashamed at what my representative (Mark Kirk) has proposed and I actually sort of like the latest take on Obamacare. So here is one issue where I side with the Democrats. A lot of good my support will do. It was clear from this meeting that the chances of meaningful health reform are all but nil. And the Democrats will have no one to blame but themselves.

The tea partiers may have been missing, but the room was still divided into two resolute camps. There were those who want to reform the system, a la President Obama. And then there were those who want to blow it up and replace it with single payer. This fondness for single payer was partly because I was joined on stage by the eloquent single payer advocate Dr. Quentin Young. But if the schism in the room was at all indicative of the party overall, then health reform is in trouble, and, I believe, for the most cynical reasons. Single payer supporters fear that if we are successful in making modest changes to the current system, there will be no call for radical change. So they reject change at all cost. To wit: when asked about Massachusetts Health Plan, Dr. Young’s major complaint was that it did not cover illegal aliens and might one day also not cover legal aliens. Does he really believe that this is the foundation for creating a political consensus around single payer?

Dr. Young and your backers: It is time to get real! We have as liberal a Congress as we are going to see for a long time. And as Dr. Young himself admitted, this Congress has fewer than 100 single payer supporters. Here is this amazing window of opportunity to enact meaningful reform, and the party in power cannot get along. It seemed that quite a few Democrats would sabotage the entire reform movement in the hope that someday things would get really bad and single payer would finally win out. (As if things aren’t really bad already.) I could sense the frustration among the more pragmatic folks in the room.

It seems to me that perfection has become the enemy of the good.

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