And no, I am not directing the “you” at anyone in particular. I apologize if this seems a crass attack, but it is not ad hominem. A few days ago, Professor Landsburg offered the insight that replacing Medicare spending with vouchers would reduce spending on medical care in the long run. How? Well, if instead of someone else footing the bill when I went to the doctor, that same amount of money would be provided to me in the form of a voucher, and given that most of us are rational, economizing beings, at the margin we would be more selective about the amount and type of medical treatment we consume.
My readers would not be surprised by this insight. But the rest of America seems to be. Read the comments to his post or on Krugman’s blogs on this topic. A few random observations:
- The “Progressives” pan this plan and any one resembling it as a matter of religion. If it were floated by Barbara Boxer, would they still pan it? Now, if Boxer ever proposed something like it, I would support it – much like I am supportive of what our Progressive Governor Andrew Cuomo has been trying to do in NY. I don’t care if an alien from Mars came down and decided it was time to recognize unicorns don’t exist, I would support a person who started from that understanding regardless of their affiliation.
- The “Progressives” (wrongly in my view) argue that spending on health care is a problem. Well, it is only a problem when people are spending other people’s money. Would they argue that since Wintercow spends over 16% of his disposable income on schooling for his children, and that this number has increased at faster than the rate of inflation over the past 4 years, that there is a crisis on our hands? But if spending is a problem, aside from the few good pieces of the ObamaCare legislation which would likely restrain cost increases a little bit, what else do they offer as a real cost reducing option. Saying “NO!” to vouchers is not exactly a way to reduce costs. Or do they think that further state-ifying health care will magically reduce costs. Even if it did reduce money costs, the total costs of such a world are not likely to differ much from today’s, they may even be worse.
- Here are my real issues. If the “Progressives” like to argue that “we spend all this money in the US and we get no better outcomes than the rest of the (preferred) world,” it is not possible to argue in the next breath that offering Medicare recipients vouchers is going to be a crisis. Why? Well, if seniors “stupidly” cannot make medical choices on their own, then not getting needed health care will not be a problem – that’s the point of the argument of “we spend too much.” And if you want to argue that seniors are not stupid, then giving them vouchers rather than the government paying doctors directly cannot possibly increase costs as compared to the status quo. So to argue that, “we should not do it because it might not reduce costs” is a total red herring.
- I politely ask, “what is the evidence that more consumer involvement via vouchers would NOT have the impacts Professor Landsburg is mentioning?” Ought the burden of proof be on folks that start with the assumption that individuals are NOT economizers? But it seems that the “Progressives” have won the discussion by somehow making the burden of proof fall on people who know unicorns do not exist.
- I am rather astounded by the “outrage” at the Ryan plan. Consider a plan where the government, today, spends the same amount of money targeting medical insurance support to its citizens. What these vouchers are talking about is putting more power in the hands of individuals. It is intended to reduce the rate of cost increase to government to get the same or better medical outcomes. So what opponents seem to be grossly arguing is that no government policy is acceptable unless it is RUN by the government. Don’t go parading around talking about health outcomes or anything else as cover for this view. It reminds me of the “environmentalists” who are aghast! that the Chinese government is subsidizing green energy technologies. It ain’t about the environment for them, nor is this Medicare dust-up about health for these people. Sorry, play again some other day.
