Drum tries to blaze a trail: Could the federal government really afford Medicare For All?
You're asking a big major question. One is tempted to voice this reply:
Not at these prices it couldn't!Why would the overall price tag possibly be a bit high? Once again, for the ten millionth time, we'll show you the remarkable data which, by upper-end rule of law, simply cannot be discussed:
Per capita spending, health care, 2018Why would it be a heavy lift to institute Medicare For All? Because, for reasons which go unexplained, we're paying more than twice as much for the product in question as those "peer nations" do.
United States: $10,586
United Kingdom: $4070
It's hard to buy a fleet of cars if you're being charged 40 grand each for a type of car which everyone else is getting for $18,000. And so it would go, right here in these states, if we decided to go with Medicare For All.
Why are we paying $40,000 each for a fleet of $18,000 cars? By some system-wide rule of law which itself goes undiscussed, your press corps refuses to wonder.
Paul Krugman tried to raise this question about health care spending in a series of New York Times columns way back in 2005. His work on this topic was met with a chorus of crickets.
The locusts also sang last month, in response to Heather Long's front-page report in the Washington Post. When Long's report raised this same remarkable question, the roaches all scurried into cracks in the wall.
That said, so it goes. So it goes when the rational animal is confronted with a blindingly obvious question.
Back in The Summer of '05, Krugman cast himself in the guardian role, attempting to trigger a public discussion of an obvious question. Economists Case and Deaton did the same thing just last month, as described in Long's report.
The question couldn't be any more obvious, but this nation's upper-end rational animals are incapable of responding. When high-ranking players like Krugman and Case and Deaton cast themselves in Plato's classic guardian role, the children enter the zombified state which has long characterized our failing nation's flailing national discourse.
They look for something else to discuss, something dumber and more entertaining. As in this BREAKING report at Slate, they never fail to find it.
Having said that, let's be fair. We've said that Heather Long's front pager report produced zero reaction, and that isn't quite the case. Our favorite blogger, Kevin Drum, flagged and discussed her report over at Mother Jones.
Drum's post raised the types of question which would be discussed if the rational animals who crawl all over our upper-end press corps were capable of rational conduct.
In his post about Long's report, Drum improved upon Case and Deaton's work in an important way. He said the typical American family is actually paying an extra $12,000 per year in health care costs, not the mere $8000 "poll tax" Case and Deaton decried.
We're puzzled by Drum's "percentage of GDP" methodology; it seems to us the actual amount of excess spending may be higher yet. Setting that side for another day, here's Drum's explanation for all the missing money which makes universal health care in this country especially hard:
DRUM (1/7/20): If we spent at the OECD average level, we’d save more than $12,000 per family. How did our health care spending get so high?Is that where all the money goes? As a general matter, does all the missing money go to a wide range of people?
That’s a complicated question, and it’s water under the bridge anyway. The real question at hand is: why don’t we make an effort to cut back to European levels? After all, they have perfectly fine health care even with much lower spending.
The answer to that is easier: It’s because most of our outsize expense comes from paying doctors more, nurses more, medical staff more, hospitals (and their workers) more, drug companies (and their workers) more, device makers (and their workers) more, and so forth. Thus, the only way to seriously cut back our health care spending is to pay people a lot less than they’re getting now, and this can be done only slowly if at all. You can’t suddenly tell doctors and nurses that they’re all getting 30 percent pay cuts. Hell, you can’t even do that to pharmaceutical companies, as much as we might like to. Aside from being massively disruptive, it would generate massive opposition. And in a democracy, massive opposition matter.
Are people in a wide range of sectors all taking an extra share, as compared to what their counterparts are paid in places like France? Is everybody taking a cut, producing our remarkable spending?
Is Drum's general explanation generally correct? Because this topic is never discussed, we have no real idea.
We can compare Drum's explanation to the one Bernie Sanders tends to supply. Again, this is the way the hopeful preached it in Las Vegas last week:
SANDERS (2/19/20): From Teddy Roosevelt to Barack Obama, this country has been talking about the need to guarantee health care for all people. And yet today, despite spending twice as much per capita, Chuck, twice as much as any other major country on Earth, we got 87 million who are uninsured or underinsured, we got over 60,000 people who die every year because they don't get to a doctor on time.That was the candidate's full explanation for the fact that we spend "twice as much per capita as any other major country."
We're getting ripped off outrageously by the greed and corruption of a pharmaceutical industry, which in some cases charges us 10 times more for the same drugs. Because of their price-fixing, five hundred thousand people go bankrupt every year because they can't afford medical bills.
In fairness, Sanders was operating within our clownish "debate" system. Within that "system," candidates are asked complex questions and are given 11 seconds to respond, with baying wolves arrayed around them interrupting the whole way through.
For some, this system produces the illusion that some version of a "discussion" is taking place. Future experts despondently hang their heads when they see this charade occur.
Back to our two explanations:
Drum gave a wide-ranging explanation for the astounding data we've now posted for the ten millionth time. Sanders offered a narrower statement, in which one lone industry was mentioned and was accused of greed and corruption.
As a general matter, Drum tended to figure us the people; Sanders fingered the corporate swells.
Elsewhere, though, the crickets spoke. The rational animals within our "press corps" began discussing (partial) statements Sander had made in 1985 about a wildly tangential matter. The pundit corps focused on those (partial) remarks, as once they thrilled to the number of buttons on Gore's suit coats and on the exciting claim that he had "hired a woman to teach him how to be a man."
This is what our upper-end "press corps" does. Anthropologically speaking, this is who, and what, they are.
Back in 2005, Krugman attempted to cast himself in the guardian role. His work was met with systemwide silence.
Last month, Case and Deaton tried to take the "poll tax" route. Drum tried to discuss what they had said, but our cable stars never did. (Neither did the candidates, just to be fully inclusive.)
Your cable stars, rational animals all, engaged in their typical conduct. Kornacki was placed before the big board and told to rattle polling data. Pointless speculation followed, hours of it at a time.
Long ago and far away, Plato imagined a guardian class. In fairness, he also claimed that we were looking at shadows on the wall of a cave.
He just may have had that part right! But did he imagine a guardian class protecting the interests of the republic? According to despondent anthropologists, the way our species' brains were wired didn't allow for such conduct.
Why does the typical American family spend so much extra for health care? The data are simply astounding. But what explains those data?
Something tells the rational animals of the press that they mustn't go there. Something tells the other animals that we shouldn't notice their silence.
Our vaunted professors don't rise to complain. Over Ireland, the silence is general.
Tomorrow: Boo, Hoyt, Concord high school students ignored