Berkeley Bob on Health Care

There is an op-ed in this morning’s Wall Street Journal by Robert Reich — President Clinton’s former Secretary of Labor and a current professor of public policy at UC-Berkeley — on the Democratic presidential candidates’ plans for national health care.

The article amazed me, not for its blatant disregard of economic logic, but rather for its presupposition of controversial facts about what universal health care coverage would be like. Reich accepts (without justification) that national health care will be affordable, universal, and comprehensive, offering excellent service for which every American will be free to choose the doctor of his or her choice without an automatic opt-in mandate. Well, by golly, if it isn’t Uncle Sam Santa. How crazy we’ve been to bicker about this.

I’m surprised the Journal let this go to print, particularly without a rebuttal. But for argument’s sake, let’s accept what Reich imagines and focus on what the article says instead. Reich argues that the Democrats should “think bigger” about national health care and ignore the petty issue of mandates (that is, whether or not uninsured Americans will be forced to participate). Reich recognizes correctly that mandates (and their big government connotations) are the most sensitive part of the health care debate, so he argues that they’re just a smoke screen. But mandates are the most important part of any universal health care plan.

Ostensibly, national health care would rely on younger, healthier participants’ contributions to subsidize the high costs of older, sicker Americans. That’s a non-partisan fact, as it’s the same rationale for Social Security and Medicare. How else can a system that offers universal coverage without distinguishing premiums remain solvent? Uninsured older Americans are the most expensive segment of the population to insure, yet we are supposed to believe that this wouldn’t pose a problem without a mandated influx of healthy Americans who contribute to the plan without utilizing its benefits?

Reich ignores this fact, and — presumably to appease the naysayers — argues instead that high-cost participants would be subsidized by the general revenue obtained from allowing the Bush tax cuts to expire. Please. Even if we were to assume that allowing the tax cuts to expire would increase revenues (it might not), address the alternative minimum tax problem (it won’t), and not push the country into recession (it probably would), there’s still the issue of how the additional revenue can even hope to offset the enormous cost of health care for millions of high-risk Americans — particularly when fixed premiums encourage health care abuses. Ironically, Reich provides his own counterargument to the importance of mandates when he cites Republican Mitt Romney’s Massachusetts health care plan (a plan which currently exempts about 20 percent of the state’s uninsured population and has left policymakers contemplating either universal coverage or insolvency). Oh, but “big government” mandates aren’t important.

Reich’s article is purely propaganda, ignoring the real argument by dismissing the bureaucratic mess of “big government” mandated coverage as the “least important aspect of what [the Democrats] are offering,” in order to appease Americans who want to believe that universal health care can be achieved without cost or government intrusiveness.

But it’s not “The Road to Universal Coverage” that Mr. Reich is offering; it’s the “The Road to Serfdom.”