Understanding The Power Of Government Run Health Insurance

In a way, it is stunning to me that someone like Matt Yglesias, who has spent the year pooh poohing the public option and arguing that it be dropped by progressives would write this:

[I]t’s important to understand that [Medicare's] low reimbursement rates are a feature not a bug. [. . .] [O]n the one hand, that funding levels are high. But it also means that there’s a reasonable amount of interest in getting as much health care services per dollar as possible. Consequently, providers are paid enough to make it worth their while to see Medicare patients, but much less than they’d like to make. The result is not a perfect program (far from it) but this particular aspect of Medicare is an example of big government at its best—serving clients’ interests rather than those of providers.

I have written it a million times - here is one million one - the one tested and proven method of controlling health care costs is Medicare. Health care reform that creates a program that COULD become like Medicare is the only proven reform that has been proposed. The wonks will tell you all about the wonderful "bending the curve" provisions like the Exchange, and the excise tax and all the rest. What they do not tell you is that none of that - absolutely none of it, has been proven to work in any setting ever. Only one program has been proven to work to cut costs - the government run insurance program known as Medicare.

Speaking for me only

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    Bravo (5.00 / 1) (#1)
    by cal1942 on Thu Dec 10, 2009 at 11:51:12 AM EST
    Unequivocal, to the point and on the money.

    This summer and fall we've witnessed a few sick jokes; Congress bending over backward to preserve a parasite and the coronation of President Snowe.

    Time squandered while millions remain unemployed.

    Oddly enough (none / 0) (#2)
    by lilburro on Thu Dec 10, 2009 at 01:47:15 PM EST
    Ezra agrees:

    Ezra Klein: The counter, basically, is that private health-care insurance is going broker, faster. Providers really aren't being driven out of Medicare. Medicaid is something of a different story. But private health insurance is seeing the opposite problem: People are being driven into the ranks of the uninsured, and businesses are ceasing to offer coverage. One is no more sustainable than the other in the long-term, and private care is actually seeing faster cost increases than public care.

    Meanwhile, other systems don't spend as much as we do, and they tend to have a lot more public involvement. So there's pretty fair evidence that the Medicare model can work well if let loose, but not much evidence that the private market can work for something like health care, which tends to confound normal economic models.

    I tell you (none / 0) (#3)
    by Big Tent Democrat on Thu Dec 10, 2009 at 01:49:25 PM EST
    the man is a puzzle. How can he write that and be such a fan of the Exchange?

    I wish someone would ask him (none / 0) (#4)
    by andgarden on Thu Dec 10, 2009 at 02:08:18 PM EST
    to show his work and explain his confidence in the exchange. If I'm around for his next webchat, I will try to do exactly that.

    Do it (none / 0) (#5)
    by lilburro on Thu Dec 10, 2009 at 02:20:06 PM EST
    or post the question if you can't make it.  I suppose he is very responsive with the answers because my question wasn't particularly great.  Plus I don't think a lot of people spend their lunch hour waiting for his health care chats to start.  So I guess regardless of policy preference I do have in common with Ezra that I am a nerd :)

    I don't know (none / 0) (#6)
    by lilburro on Thu Dec 10, 2009 at 02:33:34 PM EST
    the Healthy Americans Act improves the deficit after 4 years according to Mr EK.  But that's not actually what's on the table and it's not "the Exchange."  Plus the Healthy Americans Act seems to require really good enforcement of regulation which is an important question and would've been essential to its success.

    Anyway the funny thing is I think that Ezra is referring to the crappy Wyden Amendment that saved like, $1 billion in 10 years here:

    The changes under consideration should lower the cost of the bill. Subsidies for Medicare are cheaper than subsidies for private insurance, as Medicare is cheaper than private insurance. Wyden's plan has already been scored as a cost saver. Etc.

    Oh yeah Wyden's Amendment is awesome.  Typical Ezra BS supported by blind faith or I don't know what.


    Irony (none / 0) (#7)
    by jarober on Thu Dec 10, 2009 at 04:25:59 PM EST
    There's some definite irony in the previous post - government tabs on you - and this one.  If you don't like the government having lots of info on you, why on earth would you want a medicare style program run by them?  Do you think the end result would be less government info on you?

    Obviously you havnt (none / 0) (#8)
    by jondee on Thu Dec 10, 2009 at 04:49:12 PM EST
    been keeping up with what the base has been saying J: they're supposed to keep doing that more and more until the Rapture comes.

    Sez so in Revelations.