Monday, August 31, 2009

Obama Has Done Us a Favor on Health Care

Perhaps the biggest boost that Ted Kennedy could have given to President Obama was to give the president a week's pause.

Maybe that pause will have given him a chance to refashion his failing health-care plan. Conservative pundits high and low have been busy counting him out over the past couple of weeks. We've counted presidents out before. It doesn't work that way.

The fact is that President Obama has huge majorities in the Congress. If he'd just trim his sails a bit he ought to be able to pass a lot of very Democrat-friendly health legislation. The fact that he chose to go for the long ball has turned out to be a godsend to conservatives and Republicans, for it means that he is wasting some of the opportunity he had back in January.

But the Obama administration is doing conservatives a great favor. It is coming out from behind the screen and telling us exactly what liberals stand for. For the last twenty years, liberals have been pretending they are New Democrat centrists. They had to, because otherwise they couldn't get elected to the White House and to control of Congress.

But once Candidate Obama got elected to the presidency on a platform of transparency and tax cuts, and Nancy Pelosi got to be Speaker on the strength of conservative Democratic candidates winning in Republican-leaning districts, they threw off their disguise.

But that puts the real Democratic agenda in play. It means that conservatives like Betsy McCaughey can start writing about the real health care agenda of the Democrats.

The Democratic health agenda is really quite simple, as Rahm Emanuel's brother Zeke has laid out. Doctors are going to have to balance the personal needs of their patients with the overall needs of society.

Dr. Emanuel believes doctors should serve two masters, the patient and society, and that medical students should be trained "to provide socially sustainable, cost-effective care."

If you are an elite Democrat, this seems quite uncontroversial. Of course we are going to have to limit health care in the interests of society. Or, as Sarah Palin says, you are going to have to have "death panels." Otherwise health care will eat the federal budget.

But this elite Democratic view presupposes that health care is delivered as a government program. It presupposes that lordly experts will formulate health care policy and implement it in beneficial 1,000 page bills. Other experts will make life and death decisions about granting health care or withholding it, on a case by case basis.

But what experts like Emanuel don't consider is that it doesn't have to be that way. If health care weren't a government program, and health care were treated as a human need much like the need for food and housing, then people would have to balance their need for health care with other needs. And government wouldn't be in the position of playing God.

Of course, that means that rich Americans would get all the health care they wanted, and poor Americans would get only basic health care. In other words, it wouldn't be that different from the current situation in the United States.

It also wouldn't be that different from the situation in Canada. In Canada, ordinary people have to wait for health care. They have to endure the usual waiting lists that are universal in government health plans. But rich Canadians can hop south of the border to get urgent health care. Guess what. There's a movie about this. It's called The Barbarian Invasions.

How much health care do people want? Obviously, if health care were free, they would want unlimited amounts. But it isn't. So there has to be a limit.

When it comes to limited resources you have to have rationing. You can have rationing by price, or you can have rationing by waiting lists.

Or you can have a sensible combination. We could force Americans to pay for a decent minimum of health care, such as basic public health, accident, neo-natal, and hospice care. We could invite Americans to sign up for insurance to pay for their less-basic care if they valued it enough.

This system would be a two-tier system, of course. Kinda like the system they have in France.

Oh, you didn't know that France has a two-tier system? That's odd. I wonder why. You mean to say that Michael Moore in his SiCKO didn't quite make that clear?

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