In a recent article (Why Not Medicaid for All?), Ross Douthat offers another careful and thoughtful contribution to the Obamacare debate. Near the end of the article, he highlights what I believe is one of the most important issues at stake – the economic realities that have brought about the most competent and technologically advanced health care system the world has ever known. In the midst of all of the partisan rancor, I rarely hear this issue addressed. Douthat writes:
And this is where we start to really get down to ideological bedrock, because conservatives and libertarians (and a few liberals) then look at the European/Canadian model and say, Surely there’s a better way than that. Yes, we concede, the strictly socialized systems do seem to save money relative to our mixed, kludge-y, public-private mess. But we also think that Americans really do get something for all the extra money that we spend: Specifically, a system that appears to drive a leonine share of global health care innovation, creating the drugs and procedures and life-extending technologies that then ripple outward, improving health and life expectancy in the developed and developing world alike. And the great fear on the right is that if we, too, end up controlling costs from the top down the way other countries do, then we won’t just squeeze waste out of the system, we’ll squeeze out innovation and drive out talent as well … and worse, we won’t even know it, because we’ll just assume that the innovations that we get are the only ones there could have been.
All of his hyperlinked articles are worth reading. He make a compelling case for why the conversation about Obamacare needs to continue. I find very little anti-Obamacare rhetoric particularly helpful, as it tends to ignore moral and political realities as much as Obamacare proponents ignore economic realities. But the concern described by Douthat in the previous quote warrants the consideration of proposals like this one: How to Replace Obamacare. It’s calm and dispassionate, and accounts for the many factors involved in the debate. Very helpful.