Tuesday, January 10, 2006

Health care reform

Yesterday's WSJ contained discussions of health care reform that I found simultaneously interesting and obscure. It was interesting because of intelligent reader comments and some good comments about the limited value of making consumers pay for their medical care. But it was obscure because the writers were throwing around supposed facts that were not placed in context, and were used as debating props, rather than aids to reasoned discussion. In general, advocates don't seem to work from a common database, and many of the supposed "facts" people cite are either falsehoods or distortions. For example, wingnuts claim that malpractice law is a major culprit, but all available data suggests that malpractice cases are rare, hard to win, and barely touch the hundreds of thousands of actual malpractice.

Nobody seems to mention, any more, the carefully crafted approach worked out by Hilary Clinton and Ira Messenger in 1993, yet as far as I can tell it was the closest thing to a comprehensive and intelligent solution that we have ever had. It was defeated by partisan politics, special interest activity, and clumsy advocacy, not on its merits. I find it hard to take health care reform proposals seriously if they don't build on that proposal, or explain convincingly why not.

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