While this debate continues, there are 2 fundamental points that were overlooked, and in fact assumed as givens.

First, re: the top-down approach. The author states that affordability would not be an issue, given a payroll tax to pay for universal coverage. First, anytime a tax is levied, affordability becomes an issue for the payer - not the recipient. So, from the perspective of government, it is not an issue. For the rest of us losing more earned income, affordability in every other area is paramount. Second, the affordability issue comes into play when we think about how much health care is allocated by government for each person, but we build an inequity when we fail to connect this to how much we are willing to pay for health care. This is an important economic issue to consider.

Re: consumer driven health care, we'd see people over profits, not the other way around! People drive profits, period. Companies not providing relevant and quality services would be put out of business, so customer service would be of primary importance to providers. Also, the critics fall back on one significant if silent assumption: that people are too dumb to make choices and take care of themselves. Sadly, it is this thinking that leads us to the increasing nanny-state, causing more people to behave as if they were in daycare.

• posted by Bina Patel, Cascade Policy Institute
• December 13, 2007 @ 5:40 pm
• Permalink

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