POLICY: Slagging off Philip Longman, defending Jon Cohn

Up at Spot-on I’m defending Jon Cohn from a way-off topic review of his book from Philip Longman in the Washington Monthly. This is an important topic because Longman is in the “we can’t afford universal health insurance because the delivery system is inefficient” camp. He’s way wrong about that and he’s not alone. In fact his logic is backwards. We need to sort that out quickly, and I have a go at doing so in a piece called New America? Old Excuses. (The “New America” is the Foundation Longman is from which for some reason has teed off my editor over at Spot-on in the past). Here’s the intro:

Last week, I came to criticize Jonathan Cohn (for being too nice). Today, I come to defend him. Phillip Longman who hails from the New America Foundation complains in the Washington Monthly that Cohn’s new book Sick is Misdiagnosed because Cohn concentrates on the financial consequences of living without health insurance and not on the overall problems with inefficient and ineffective care in the U.S. system. He doesn’t exactly get off to a roaring start, taking Cohn to task and getting it totally wrong in the process.

Read the rest and come back here to comment

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Matthew HoltBrian KlepperBarry Carol Recent comment authors
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Matthew Holt

Brian & Barry are as usual both very sensible and both right–we do need to deal with the issue of overuse and poor incentives. Medicare, which is a politically dominated single payer program, does not, as they both point out, deal with the inefficiencies in the US system. But it can cut costs. It did it in 1998 with the BBA. More importantly other countries have both used their single payer systems to contain costs (Japan/Canada in the 1990s both reduced the share of GDP going to health care) and others (UK, Denmark) have used their single payer systems to… Read more »

Brian Klepper
Brian Klepper

Universal coverage and cost controls are the yin and the yang of a workable system. Neither alone is adequate. Universal coverage may facilitate some cost management, but it is more about access, distributing risk and financially stabilizing the safety net. Without universal coverage, as enrollment in coverage continues to erode, the safety net will ultimately collapse under the weight of the growing numbers of uninsureds and underinsureds. The turmoil will gradually spread to the rest of health care and then, because health care is our largest economic sector, to the larger economy. And many in the middle class will go… Read more »

Barry Carol
Barry Carol

Jonathan Cohn is a single payer advocate who wants to drastically reduce the role of private insurers and replace them with a one size fits all Medicare system for everyone. He readily admits that both Medicare and Medicaid are prone to fraud. Choice (which is an important part of our culture) would be eliminated. Then he not so reassuringly tells us that Medicare for all would be no worse than what we have now. Hospitals often argue vociferously that Medicare does not cover their full costs, and Medicaid is even worse. They can make the system work largely by shifting… Read more »