Many things are interesting about Paul Krugman’s recent health care piece. John C. Goodman has a good rundown of some of the problems with Krugman’s factual claims. What I find most striking is that, in all his obsessive concern over how to distribute health care, Krugman displays a total lack of interest in the political conditions necessary for the production of health care.
Understandable. Krugman’s plan for “distributing” health care would cripple the production of health care. Heck, it already is.
Krugman’s argument, for those of you won’t endure seven-hundred words of leftist apologetics, runs like this: Health coverage (whether by government or by private insurance) promotes health, therefore anyone who opposes government programs to expand health coverage is an enemy of health.
But you can’t equate health coverage with health care. What individuals want is care. Coverage is at best a means to that end. Health care refers to the actual medical attention and treatment that extend and improve our lives.
If you want to wade into the waters of the health care debate, your first obligation is to identify what actual health care depends on. What political conditions ensure a ready supply of skilled, knowledgeable doctors? Of emergency rooms and hospital beds? Of increasingly advanced and affordable technology and medicine? Of increasingly improved understanding of human health?
As in any productive endeavor, the basic answer is: the free market. Three quick examples:
- Why are U.S. cancer outcomes generally superior to socialized systems? Because socialized systems are rife with shortages: of doctors, medical equipment, hospital beds. . .everything. As result people wait longer, and the treatment they do get is determined, not by their own judgment based on their doctor’s advice, but by bureaucratic dictates.
- Why is the U.S. by far the world’s leader in pharmaceutical innovation? In significant part, because—despite the massive amount of government intervention in U.S. health care—we still in many ways have the freest system in the world. In particular, drug prices are set (largely) by the market, not government, and so pharmaceutical companies can profit by introducing new drugs.
- Why is Lasik eye surgery defined by innovation and falling prices? Because it is substantially freer than other parts of the health care industry .
Krugman ignores all of this. Expand health coverage, get more health care: That’s his mantra, and he uses it to tout government schemes such as Obamacare, virtually accusing his opponents of murder.
Now set aside the fact that government, by driving up the cost of health care and health insurance, bears primary responsibility for the fact that so many Americans lack coverage. And set aside the fact that no one has a right to health care, bought and paid for by others. Set all that aside for a moment and remember this:
Government-expanded coverage can get people into waiting rooms, and in front of people with white coats. But it cannot produce health care. Only individuals can do that—and only to the extent they are free.