Krugman, Douthat, and Healthcare

They duel on the Times Op-Ed page today.  Krugman makes an important point:

The real risk is that health care reform will be undermined by “centrist” Democratic senators who either prevent the passage of a bill or insist on watering down key elements of reform. I use scare quotes around “centrist,” by the way, because if the center means the position held by most Americans, the self-proclaimed centrists are in fact way out in right field.

Which Douthat fails to grasp:

In a world without political constraints, it wouldn’t be hard to create a fiscally responsible alternative. Conservatives would encourage people to self-ration, by putting a certain number of health care dollars directly in their hands and leaving the rest to market forces. Liberals would ration more directly, by slow-walking Americans into a public health care system, whose cost-conscious, evidence-weighing bureaucracy would pay for procedure X but not procedure Y, surgery P but not prescription drug Q.

That is, it ain’t just “liberals” who want a public health care system, it’s 72% of the population.  The fact that status quo apologists fail to acknowledge this isn’t exactly surprising, but it’s more than a little discouraging.

And, as a gripe, I really don’t appreciate the snark in Douthat’s phrasing about a “cost-conscious, evidence-weighing bureaucracy.”  We know it’s snarky, because Douthat is a conservative and conservatives hate bureaucracy almost as much as they love American flag pins on our elected officials’ lapels.  But Douthat concedes that our current system is “overpriced, bloated and hugely inefficient”–so what the fuck is wrong with being cost-conscious?  Or weighing evidence?  What’s going on here?  Oh, I know:  Douthat’s trotting out the conservative bogeyman about fears of the government “rationing” our health care.  Well, as Digby points out:

The idea that the US doesn’t ration health care is absurd. We certainly do. We just make people do it to themselves out of economic hardship. I guess that’s supposed to be a tribute to our sense of individualism and personal freedom.

Hey, nobody’s going to tell you you can’t be treated — you made that decision all by yourself when you opted not to have a lot of money. That’s what freedom’s all about.

Moral of the story:  Please give me some healthcare.


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