May 16, 2006
Health Care II Posted by John Steele Gordon at 12:20 PM EST I am glad to see that Joshua Zeitz and I are not entirely on separate pages of the hymnal when it comes to health care. Just a few comments: 1) He writes, “In effect, the private sector promised to build and maintain the safety net. . . .” Since the “private sector” is, in reality, everything that is not government, I don’t see how it can promise anything. The deal cut between General Motors and the UAW bound GM and the UAW (and, in effect, the rest of the auto industry), not “the private sector.” The greatest attribute of the private sector is that it does not and cannot act monolithically. 2) Mr. Zeitz writes, “. . . by agreeing to let responsibility for health care rest with private industry, workers left themselves at the mercy and discretion of their employers.” Again “workers,” except in so far as they are represented by unions, cannot act collectively. As for the auto workers, they were hardly at the mercy of their employers. Indeed, General Motors employee health benefits became so extraordinarily generous over the years that they are bankrupting the company by making it uncompetitive.
3) He writes, “By the 1980s, a powerful combination of global competition and sheer greed emboldened many firms to cut or cancel out pension plans and health insurance, thus shifting risk back to working Americans.” I think that global competition may have forced firms to cut back benefits but hardly emboldened them except in so far as necessity can make one brave. The “defined benefit” pension model seemed like a good idea in the low-inflation, life-time-employment-model world of the postwar years. In the new globalized economy of recent decades it has proved an economic disaster for employers and employees alike.
As for “greed,” it is one of the seven deadly sins to which all flesh—not just that of corporate executives and their stockholders—is equally heir. Labor unions have often succumbed to greed, to the great long-term harm of their members. The GM health plan as it evolved is an example. And politicians are quite as likely to be greedy as any corporate executive. Sometimes they are greedy for money, such as Congressman Duke Cunningham, now in a federal pen. Far more often, they are greedy for power. Their urge to take control is hard to satiate. That is what makes me so wary of the “cooperatives” proposed by Hillary Clinton’s health care task force. 4) He writes, “the private sector made a solemn promise in the 1940s to provide for Americans’ health insurance. If it cannot or will not continue to honor that pledge, then we need to revisit the idea of state-financed or state-run health care.” Again, “the private sector” cannot promise anything. In this case, Mr. Zeitz seems to be using the term as a synonym for “corporations.” They, too, never acted in concert (which would have been illegal in any event). I only wish the accidents of war and politics that led to corporations being the main providers of health insurance could be undone. In a perfect world, employers would have nothing to do with providing health insurance other than providing the money for their employees to purchase it.
5) He writes, “. . . economists like Paul Krugman argue that America’s health care economy is inefficient.” There was a time, I suppose, when Paul Krugman could have been described as an economist. And perhaps in his classes at Princeton he still is. But in his column in The New York Times, Mr. Krugman is nothing but a propagandist for the left in American politics. His columns remind me of Mary McCarthy’s famous description of a book by Lillian Hellmann, “Every word she wrote was a lie, including ‘and’ and ‘the.’” Even the first public editor of the Times, Daniel Okrent, no right-winger by a long shot, felt obliged to publicly rebuke Krugman’s intellectual dishonesty and refusal to acknowledge even the most unquestionable errors.
Tomorrow I’ll try to outline my ideas for creating an efficient, affordable, reliable health-care system in this country. At least, I’ll outline what it should look like. The political hurdles getting there will be tremendous. I agree wholeheartedly with Joshua Zeitz that the plan offered by the federal government to its employees is an excellent model. I also agree that greed is a big problem, as it always is in human affairs. But corporate greed, union greed, political greed, and individual greed, in my view, are all part of the problem.
|
