Here’s his New Republic piece called Health Care Like The Europeans Do It republished on CBS news. Personally I think that he gives the American system too easy a ride, even though Ezra beats up the Cato boys on this too. When I looked at this issue of performance on particular disease categories a while back I found this quote.

Contrary to popular belief, the health care here isn’t always the best. Many other industrialized countries provide health care that is just as good and sometimes better. For instance, 30-day acute myocardial infarction case-fatality rates are below 7% in Denmark, Iceland, and Switzerland, compared with almost 15% in the United States. Incidence of major amputations among diabetic patients in Finland, Australia, and Canada is less than 10 per 10,000 compared with 56 per 10,000 in the United States. And Australia, Canada, England, and New Zealand all have a better 5-year kidney transplantation survival rate than the United States.

You’ll never hear that in a Cato/Manhattan/PRI/AEI press release—and it defies belief that they want to go down that path.

But the overall point is that health and medical services are only distantly related, and talking about outcomes in the context of different health systems is stupid. But there are two outcomes that it is not stupid to talk about, and those are the two on which America leads the world. High costs across the system, and poor (and middle income) people losing all their wealth due to medical care costs.

After spending his whole piece beating back the silliness about individual disease outcomes, Jon does get to the real point:

Not even conservatives dispute the one clear advantage other countries have over us: You don’t see their citizens choosing between prescriptions and groceries, or declaring bankruptcy, because of medical bills.

And that is the point. Universal health care insurance is not about health, it’s about wealth. As in not losing it when your sick because you didn’t have good health insurance. Because as I’ve said before on THCB good insurance is mostly a function of good employment, which is mostly a function of good education, which is mostly a function of how you choose your parents.

As John Edwards put it when he announced his health care plan, "It doesn’t have to be that way."

OK. The bickering about Jon Cohn’s new book Sick has started over at TPMCafe Book Club. Lots of interesting stuff including one from moi.

Jonathan Cohn’s book Sick is out today. The early version of some of the chapters I read was fabulous, and I’m really looking forward to reading the whole thing. If you want to buy it follow this link and click on it here there & I get the odd shilling, I think

I like Michael Cannon a lot, but I fear his (and Michael Tanners’s) book (unlike fellow Cato-ite Arnold Kling’s) was very, very weak on dealing with the problems of actually sick people. It devoted a whole three lines to the problem of what happens to controlling costs beyond the deductible–even though everyone knows that that’s the most expensive part of health care. Kling at least knows that covering them is a problem, although he never really comes up with answer either (he does dance around the edge of high risk pools for the chronically ill).

But  I just assume the liberal LA Times is carrying this op-ed from the two Michaels as part of its affirmative action program. Cannon and Tanner have amazingly discovered that universal insurance does not mean immediate access to any care anybody might want for free. And so they have decided that lots of people not having insurance is therefore OK.

There are two basic problems with this logic.

First, and this is barely worth saying, but care is rationed in the US just as much as it is elsewhere. if you don’t believe me, believe the capitalists at the Wall Street Journal—who ran a long series on it in 2003, and believe fellow free-marketeer John Goodman. So saying that people have to wait for care in Europe or Canada is true but not an immediate indictment of their health care systems. Of course rationing of health care may not impact Cato scholars or even hopefully liberal health care consultants in San Francisco, but it sure as hell impacts poor uninsured people waiting for care in (say) Galveston, Texas.

Second and this much more important—a universal health insurance system means that the insurance is universal. What does insurance do? Insurance ensures that if you are not financially wiped out from a disaster, such as having your house burn down or in this case, being sick.

There’s no point rehashing the bankruptcy statistics here—the point is that the key reason the Europeans, Canadians and Japanese support their universal insurance systems is because they know that a spell of illness does not  mean financial destitution. Here it is quite possible that it will, and in many cases it does–but don’t worry it’s only one quarter of bankruptcy cases. Barely worth bothering about, eh?

That the Cato boys couldn’t even address this—which is by far the most important problem with the US lack of universal health insurance—is presumably because the LA Times was too cheap to give them more words. At least I assume so. It can’t be that they think it doesn’t matter, can it?

CODA: Meanwhile I just found out that John Goodman has a blog.It’s called The John Goodman Health Blog. I’ve been there poking a little fun in some of the comments, including this one about the bankruptcy issue. I suggest you all go there to check it out too and join the intellectual giants like Pauly, Herzlinger, Pipes et al in the comments.

Meanwhile, since we’re going on about LA Times op-ed pieces on health care, on Sunday Erza Klein has one somewhat misleadingly titled This time, we want healthcare reform. It’s really a study of what went wrong in 1993–4 and how to not have that happen again. As I was reading it I noticed that Ezra had done his homework over here at THCB, but waas nice enough to say so and drop my name in his piece.