The Oxford University Press in the US has its own blog. Who knew? As a Cambridge man I shudder at promoting anything from the dark blue side of the British divide, but Jill Quadagno (who’s book on why we don’t have national health insurance was reviewed by Jonathan Cohn and mentioned in this earlier THCB post) has written a piece on why she believes healthcare is a critical national competitiveness issue". I’m not sure I really buy that argument too much — the US is too strong in some industries and too weak in others for the 15% labor cost differential that health care makes to be too big a deal overall–although obviously it makes some difference at the margin as to where GM will put its next car plant. It does seem to me that their overall problem is that they stopped making great cars in 1969.

What is more important, I believe, is that a dollar spent on health care is a dollar not spent on education, alleviating homelessness, conserving energy, etc, etc (although apparently not one also not spent on invading Iraq, running a punitive war on drug users, or building more and more prisons) — so that we should be wondering why we are spending so much on health care, and wondering what we are getting for that spending.

And as I’ve said many times in THCB, the existence of uninsurance means that there is the opportunity for the health care system to force those who can’t afford it out of the system, and therefore enables the system as a whole to increase its costs without having to be concerned about the overall impact of this price effect. If there was some mechanism by which the extra costs were capped within the system, without the safety valve of uninsurance, life would be very different. And that’s why solving the uninsurance issue is also the solution to solving the cost issue.