HEALTH MATTERS: Zakaria dreams the impossible dream!

TUESDAY, APRIL 4, 2017

Part 2—Endorses "single-payer:" Could Donald J. Trump, the American president, ever support "single-payer?"

Everything is possible! And last Friday, in the Washington Post, Charles Krauthammer said he could imagine that very thing. For background, see yesterday's report.

For Charles, single-payer is a lousy idea. For Fareed Zakaria, Donald J. Trump supporting single-payer seems more like the so-called impossible dream—the dream which, like the famous engine, maybe just possibly could.

In last Friday's Washington Post, Zakaria and David Ignatius wrote their own columns about health care. Ignatius said we should be embarrassed by the "high cost and poor care" provided by our health system.

Before the week is done, we'll suggest that we liberals should be embarrassed by discussions like the one Ignatius provided. Today, though, let's focus on Zakaria's impossible dream.

Zakaria dreamed the impossible dream. Ridiculous headline included, he laid it out like this:

ZAKARIA (3/31/17): Until recently, Trump got health care right

The recent Republican debacle on health care could prove to be an opportunity. It highlighted, yet again, the complexity of the U.S. system, which continues to be by far the most expensive and inefficient in the advanced world. But President Trump could actually use the legislative collapse to fix health care if he went back to basics and to his core convictions on the topic, which are surprisingly intelligent and consistent.

[...]

Trump has now taken up the call to repeal Obamacare. But until recently, health care was actually one of the rare issues on which he had spoken out, before his campaign, with remarkable consistency. In his 2000 book "The America We Deserve," he wrote:

"I'm a conservative on most issues but a liberal on this one. We should not hear so many stories of families ruined by healthcare expenses. ... We must have universal healthcare. ... The Canadian plan ... helps Canadians live longer and healthier than Americans. There are fewer medical lawsuits, less loss of labor to sickness, and lower costs to companies paying for the medical care of their employees. ... We need, as a nation, to reexamine the single-payer plan, as many individual states are doing."

Trump was right on this issue for much of his life. He has now caved to special interests and an ideology unmoored by facts. He could simply return to his convictions, reach out to Democrats and help the United States solve its health-care crisis.

All edits, save one, by Zakaria. That's the way his column began and ended.

As with Krauthammer, so with Zakaria. He seemed to imagine Donald J. Trump embracing single-payer!

That said, Zakaria's column struck us as phantasmagoric. We refer to his assertions about Donald J. Trump's "core convictions" concerning health care.

Does Donald J. Trump really have "core convictions" on the topic of health care? Zakaria seemed to say that Trump has been "consistent" and "right" about health care "for much of his life."

But alas! In support of this claim, Zakaria cited a passage from a 17-year-old book, a book which was written when Trump was considering an earlier White House run in a reform-minded party. He cited no other evidence in support of the apparent claim that Donald J. Trump has long held a "core conviction" about single-payer.

To what extent does Donald J. Trump have any such core convictions? Zakaria failed to note the ludicrous statements about health care persistently made by Candidate Trump during last year's campaign.

Presumably, the candidate only said those ridiculous things because he'd "caved to special interests and an ideology unmoored by facts." But his statements went all over the place. Together, they made little sense.

Does Donald J. Trump hold "core convictions" about universal health care? We'd say it's possible, but only in the sense that everything is. We see few signs that Donald J. Trump has core convictions about much of anything in the policy realm. We don't know why Zakaria would include health care on this puny list.

At any rate, Zakaria's piece accompanied the column in which Krauthammer imagined Trump embracing single-payer. Last Friday was Health Care Day in the Washington Post, and a day of exceptional dreams.

It was clear from Zakaria's piece that he himself supports the idea of single-payer. More precisely, he supports the idea of single-payer or of something equivalent.

As Ignatius did in his own Friday column, Zakaria said we spend too much on health care—far more than the better-run developed nations. In this passage, he detailed their obvious smarts, as opposed to our own dysfunctions:

ZAKARIA: Every advanced economy in the world has...adopted some version of a state-directed system for health care. Consider the 16 countries that rank higher than the United States on the conservative Heritage Foundation's Index of Economic Freedom. All except Singapore (which has a unique state-driven approach) have universal health-care systems that can be described as single-payer (Medicare for all), government-run (the British model) or Obamacare-plus (private insurance with a real mandate that everyone opt in). Hong Kong, often considered the most unregulated market in the world, has a British-style government-run system. Switzerland, one of the most business-friendly countries, had a private insurance system just like the United States' but found that, to make it work, it had to introduce a mandate.

While producing a CNN documentary on health-care systems around the globe, I was particularly struck by the experience of Taiwan, another free-market haven. In 1995, 41 percent of its population was uninsured and the country had very poor health outcomes. The government decided to canvass the world for the best ideas before instituting a new framework. It chose Medicare for all, a single government payer, with multiple private providers. The results are astonishing.

In his own column this day, Ignatius said we should be "embarrassed" by our system's high costs and poor results. Zakaria was saying much the same thing.

Zakaria seems to think that sensible developed nations will "adopt some version of a state-directed system for health care." We are inclined to agree. In the passages we've posted, he twice endorses "single-payer" (among other possibilities). He twice equates "single-payer" with "Medicare for all."

We think that turn of phrase can serve as a gift to us liberals. It lets us consider the way our self-impressed tribe's ineptitude has kept our nation locked in the startling health care mess Ignatius and Zakaria (euphemistically) describe.

We raised the question yesterday; we raise it again today. What does it mean when we liberals refer to Medicare as "single-payer?" In what sense are we proposing "single-payer" when we propose "Medicare for all?"

We'll repeat our judgment from yesterday. We'll guess that very few liberals could explain why we call our nation's Medicare program a form of "single-payer." In this, as in just about every thing else, we liberals—like Those People in Oklahoma—often have no freaking idea what we're talking about. We the liberals rarely have the first freaking earthly clue.

In reality, the lunacy of our health care system extends well past "embarrassing." This lunacy has lived, for decades now, in the womb of our self-impressed tribe's dumbness, ineptitude, laziness, incoherence.

We liberals! Along with just about everyone else, we're among the dumbest people on earth. Despite this fact, we tend to be sure of our greatness. We saw this reflected in yesterday's post by Kevin Drum, in which a highly advantaged person who 1) supported the war in Iraq and 2) told us on a weekly basis last year that Candidate Clinton couldn't lose (he knew this because Professor Wang said) found a way to kick down at much less advantaged people Over There.

Those People! They displayed their dumbness, and their hearts of darkness, by voting for Donald J. Trump!

Our liberal tribe loves kicking down; as with every other tribe, it's deeply bred in the bone. We kick down at the hillbillies, and at the Okies too. As we do, we fail to notice the world-class cluelessness we ourselves, and our ridiculous leaders, have brought to the health care pseudo-debate for the past many years.

It's the oldest story known to the race; it accompanied our crawl from the swamp. Our own tribe is smart and good. Theirs is evil and dumb.

In fact, our own liberal tribe has been tremendously dumb through the years. Inevitably, as part of the package, We're completely unable to see this.

In accord with the oldest of prehuman laws, We can't see the dumbness of Us. Instead, We believe in the greatness of Us, and We enjoy kicking down Over There.

Tomorrow: Ignatius seems to sound off

While we're at it, riddle us this: Why is our Medicare program called "single-payer?" We can't exactly say.

While you're at it, tell us this: Why were all those "flat tax proposals" described as flat tax proposals?

In recent years, such proposals seem to have gone the way of the dodo bird. But why were they ever called flat tax proposals?

Did you ever see our underwhelming, lead-exposed leaders ask?