POLICY: Ezra Klein world takeover on track

Ezra Klein is famous today–he has (I think) his second fifth or sixth op-ed in the LA Times, and this one is about universal healthcare and whay that debate is coming back. My only problem with the debate coming back now is that I think it’s too soon and things aren’t bad enough for us to get to more than the debate–as in get an actual solution. But then I’m a pessimist.

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  1. It would be more than nice if commentators were careful to be clear about the fundamental difference between health care and health insurance. But many commentators – unfortunately even well-known ones such as Ezra Klein – aren’t so careful.
    Instead, they often seem to mean the term “healthcare” as a codeword that refers to and mixes together both health care and health insurance. It confuses health care with health insurance, it confuses the different problems associated with each, and it confuses the readers. I think it’s carelessness.
    For example, why is health insurance expensive? Because “profits” are high? Piffle. The cost of health care is clearly the most important factor in the cost of health insurance. Health insurance is expensive because health care is expensive. The cost of health insurance is rising because the cost of health care is rising. The cost of health care is the deeper problem. Blurring the difference between health care and health insurance obscures these important distinctions. That gets in the way of analysis. It results in misunderstanding. It results in fruitless debates among people who are confused over the facts. It eventually leads to faulty policy recommendations.
    Why would analysts blur the difference between health care and health insurance? Who knows? I can think of several possible reasons. (1) they don’t understand the difference (2) they don’t care (3) they have an agenda that is served by confusing the public about the issues (4) they truly believe that any difference doesn’t matter. (5) they truly believe that there is no difference. IMO, taking any of these positions is an embarrassment to anyone who wants to be a thought-leader in health care.
    An example – look at the end of Klein’s 5th paragraph:
    “And so they did, creating the employer-based healthcare system.”
    Does anyone believe that we have an employer-based “healthcare” system? Health care in this country is provider-based, NOT employer-based. And thank goodness for that. Group health insurance is employer-based. Is that what Klein means? Then why doesn’t he say so?
    Another example? Look at the start of Klein’s 6th paragraph:
    “But healthcare was simpler in the 1940s, and far less expensive. In the 21st century, it’s not simple at all. Once a perk of employment, health insurance is now a necessity”
    What is he talking about? “Healthcare”? “Health Insurance”? How can anyone tell?
    From the 6th paragraph on Klein is in full cry about health insurance, not “healthcare” If the goal of this article is to present the reader some persuasive argument about health insurance then why does Klein seem to want his readers to think he’s talking about health care?
    The confusion on this point is important, because it diverts attention from the deeper problem to the symptom. You would not accept a doctor’s failure to treat the ailment, instead being satisfied to treat only your symptoms. Why accept the same failure from health care analysts – or politicians?
    This nation truly faces a crisis of health care costs that cries out for solutions. The symptoms of this crisis include unaffordable health insurance and millions of uninsured Americans. Solutions to the problem of high health care costs must explicitly address health care costs. Duh. Addressing other problems that do not relate to the cost of health care – but at the same time pretending that they are about “healthcare” – is IMO wishful thinking that will not solve the health care cost problem. Duh again.
    I’m a benefits manager who would welcome a practical solution to the problem of high/rising health care costs. I don’t know how that would happen. So I must rely on policy analysts and politicians to figure out some kind of solution. But when I read articles like Klein’s, I must admit I grow terribly discouraged.

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