If the definition of insanity involves doing the same thing over and over again expecting different results, Democrat Senator Max Baucus is as crazy as a rat in a barrel. 

The health care plan he just announced has the same features that doomed every state-level universal coverage plan. John Goodman provides an example:

The Baucus plan includes many of the same elements implemented in the Massachusetts mandated health plan, which is now suffering from massive cost overruns for the state and escalating premium costs for consumers. 

This is exactly what has happened every time this economically illiterate strategy has been attempted. You can’t repeal the laws of economics by government fiat.

I guess the bright side of this idiocy is that Baucus and the people who now control our government will prove once and for all that they are unable to learn from experience.

Maybe that will cause the voters to give them the bum’s rush—-again.

The WSJ has a good op-ed on the effect a Democrat Congress will have on our new President. On health care, for example, Pete Stark will “encourage” him to abandon his “centrist” health care plan and go for single-payor.

The Chairman of a crucial House subcommittee dealing with health care doesn’t think Mr. Obama’s proposal to significantly federalize the insurance market goes far enough. He wants a single-payer system like Canada’s. Mr. Obama may want to strike a deal with Senate Republicans on health care, but Mr. Stark will be pulling him left at every turn.

Obama’s record is one of “going along to get along,” so I don’t see him putting up much of a fight on this.  In fact, he was for single-payer before he ran for President. So they probably won’t have to push him very hard.

Also, as I have pointed out before, Senator Kennedy is working hard on a Medicare-for-All bill, for which his impending demise will create considerable congressional momentum.

With Pete Stark and Kennedy pushing hard for single-payer, and Obama only recently against it for the sake of political expediency, is it not obvious what’s going to happen on health care next year?

While Barack Obama runs for President on an ostensibly ”moderate” health care reform proposal, his accomplice Ted Kennedy is busy putting together the actual program they plan to shove down our throats:

From his sickbed, Sen. Edward M. Kennedy has secretly been orchestrating meetings with lobbyists and lawmakers from both parties to craft legislation that would greet the new president with a plan to provide affordable medical coverage to all Americans, a measure he has called “the cause of my life.”

Obama claims he isn’t for a single-payer system, but he has made no attempt to discourage Kennedy from producing a piece of legislation calling for Medicare-for-all:

Mr. Kennedy is also moving with the knowledge of the presidential candidate who’s now leading in the polls, Sen. Barack Obama.

Here’s how this will come down if “the One” winds up in the White House. He will be presented with the Kennedy legislation in January. And he will sign it, throwing his own phony plan over the side. 

Obama will ask for a few changes just for CYA, but the plan we end up with will be just the sort of single-payer boondoggle he and his supporters claim he doesn’t want.

Then there will be the inevitable appeal an to public sympathy because Kennedy is going to kick the bucket soon, and this is likely to be his final hoorah in the Senate:

There will be a very strong impulse in the Congress to do things for him, especially things he really cares about, and health care would be at the top of that list.

There is no word, of course, on what Mary Jo Kopechne thinks of Kennedy’s plan.

I wonder how many state-level “universal coverage” plans have to crash and burn before the advocates of government-run health care figure out that they don’t work. The latest such plan to slam headlong into the laws of economics is The Keiki Care program in Hawaii:

Hawaii is dropping the only state universal child health care program in the country just seven months after it launched.

Why? Because, like all such programs, this one cost too much:

Gov. Linda Lingle’s administration cited budget shortfalls and other available health care options for eliminating funding for the program. 

And, while failing to solve the uninsurance problem, the program crowded out private insurance:

A state official said families were dropping private coverage so their children would be eligible for the subsidized plan.

And Hawaii’s ill-considered plan, as Michael Cannon of Cato points out, has much in common with Obamacare: 

[Obama] would waste taxpayer dollars on people who can already afford coverage on their own.  He would draw millions into government health programs that would threaten their access to care.

If the voters are foolish enough to put Obama in the White House, and he colludes with a Democrat-controlled Congress to implement his health care plan, we will see exactly the same result on a national scale.

The laws of economics are stubborn things.

Phillip Klein points out an interesting development in the health care debate:

When it comes to health care, it’s actually conservatives who are offering change, and liberals who are offering more of the same failed policies (only on a much grander scale).

McCain’s health care plan calls for the elimination of the horribly inequitable and inefficient employer-based health insurance system. Obama, the ostensible progressive, is for sticking with the status quo:

The Obama campaign has taken to calling John McCain’s health-care plan “radical” and Barack Obama himself declared during Tuesday night’s debate that it would “lead to the unraveling of the employer-based health care system.”

If ever a system needed “unraveling” this is it:

The current system discriminates against those who seek to purchase their own health insurance, because it only offers a tax exemption for those who get insurance through their employers. As a result, many self-employed Americans cannot afford health insurance, even though their taxes help subsidize others.

McCain’s plan would go a long way toward fixing this situation:

McCain’s plan would make the system fairer by ending the tax exemption for health-care purchased through one’s employer and replacing it with tax credits of $2,500 for each individual and $5,000 for every family.

Meanwhile, Obama wants to exacerbate the problem:

Obama would not only maintain the current system of regulation, but he would implement onerous regulations at the national level.

I thought “progressives” were for, like, progress. Did I miss something? Is their progressivism just a social pose?

A trademark lie that has been consistently promoted by the Obama-Biden campaign is that  John McCain will tax everyone’s health care benefits. Joe Biden said it during the recent VP debate, and Barack Obama repeated it in tonight’s Presidential debate:

Now, Sen. McCain has a different kind of approach. He says that he’s going to give you a $5,000 tax credit. What he doesn’t tell you is that he is going to tax your employer-based health care benefits for the first time ever. 

This charge, like so many of the talking points that emerge from the Obama campaign, is pure fiction. When Biden told that whopper, the Washington Post gave him two Pinnocchios:

According to the nonpartisan Tax Policy Center, the McCain proposals would result in a net benefit of $1,241 to the average taxpayer in 2009.

But the Obama campaign is apparently convinced that this “tax your benefits” whopper will scare some voters into his corner, so they keep repeating it.

Hugh Hewitt interviewed Sarah Palin, and she made a good case for electing a real person to the office of VP. She also made it clear that she’s the only candidate in recent memory to have experienced the day-to-day health care travails of the average working person:

Early on in our marriage, we didn’t have health insurance, and we had to either make the choice of paying out of pocket for catastrophic coverage or just crossing our fingers, hoping that nobody would get hurt, nobody would get sick.

But, unlike her opponent, she understands that more government meddling in the health care market is not the answer:

I support flexibility in government regulations that allow competition in health care that is needed, and is proven to be good for the consumer, which will drive down health care costs and reduce the need for government subsidies.

So, who are we to trust: someone who has actually been there or the hopelessly out-of-touch Joe Biden? In other words, do we need a real human being like Palin or a corrupt buffoon?

It will be interesting to see if Gwen Ifill, the moderator of tomorrow’s debate whose fawning book proves she’s in the tank for Obama, asks a question that gets anywhere near this basic issue.

As I have pointed out before, the one health care position John McCain and Barack Obama have in common is their wrong-headed support of prescription drug reimportation. It appears, however, that both candidates may be waking up:

Barack Obama and John McCain are reviewing their support for allowing individuals to import cheaper prescription drugs in light of tainted medicines and other goods made in other countries, their advisers said on Thursday.

Unfortunately, the myriad economic and safety issues that militate against reimportation have still not quite convinced them that they were just wrong on this issue:

Neither adviser said their candidate had abandoned reimportation, but had realized it would be more difficult.

One must, I suppose, make allowances for the fact that these guys are politicians. Presumably they will eventually decide to deep six this exceptionally dumb idea.

Although we can safely disregard the WSJ piece by David Cutler and Brad DeLong on Obama’s health care plan, there is an excellent article on the plan in Health Affairs, and its conclusion is not flattering:

It greatly increases the federal regulation of private insurance but does not address the core economic incentives that drive health care spending. This omission along with the very substantial short-term savings claimed raise serious questions about its fiscal sustainability.

Its ”play or pay” feature and potential for private insurance crowd-out also trouble the authors:

Heavy regulation coupled with a fallback National Health Plan and a play-or-pay financing choice also raise questions about the future of the employer insurance market.

This is a detailed, intelligent though somewhat dry piece. But if you want an honest, realistic assessment of Barack Obama’s health care plan,  it’s well worth a read.

Last year, I took issue with a “study” which claimed to show that 50% of bankruptcies were caused by medical bills. At that time, I pointed out that a couple of researchers checked the data and discovered that only 17% of bankruptcies could be plausibly attributed to medical bills.

Well,  it turns out that the actual number is only 5%. Researchers at UC Davis have found that reckless  overspending has driven most personal bankruptcies, and that medical problems are not even the second most prevalent cause:

Zhu [the study’s author] concluded that debt accounted for more than 50 percent of recent bankruptcies, while medical problems caused just 5 percent and unemployment led to only 13 percent.

So, how did the authors of that original study reach conclusions so much at odds with those of other researchers? Well, its authors run PNHP, an advocacy group committed to foisting single-payer health care on the American public.

In other words, doctors Woolhandler and Himmelstein fudged the data in their widely publicized “study” to support their political agenda. Happily, there are still a few honest researchers out there whose work can actually be trusted.

That’s right. Progressive tut-tutting about “health care disparities” notwithstanding, it turns out that we spend almost exactly the same amount of money on health care for the poor as we do for the rich. Robert Samuelson reports the following in Newsweek: 

On average, annual health spending per person—from all private and government sources—is equal for the poorest and the richest Americans. In 2003, it was $4,477 for the poorest fifth and $4,451 for the richest.

This information comes from a study conducted by economist Gary Burtless of the Brookings Institution, who was evidently not expecting such results:

Burtless was understandably astonished when he assembled these data … Probably in no other area, notes Burtless, is spending so equal—not in housing, clothes, transportation or anything.

Samuelson quotes the Burtless study to show that the health care debate often revolves around phony issues. To that end, he also points out that medical outcomes for the uninsured don’t differ significantly from those of the insured:

Outcomes differed little … After about six months, 20.4 percent of the insured and 20.9 percent of the uninsured judged themselves “better”; 32.2 percent of the insured and 35.2 percent of the uninsured rated themselves “worse.” The rest saw no change.

These data about spending and outcomes will surprise many and be denied by many others. But if we are ever going to fix health care, we will have to stop allowing everyone to bring his own “facts” to the debate.

Last week I did a brief post on Governor Palin’s effort to repeal Alaska’s burdensome and counterproductive Certificate of Need statute.  I’ve done a more detailed piece on that initiative and the CON issue for the American Spectator. Here’s an excerpt:

State CON laws originated, like so many bad health care ideas, with a mandate from the federal government. In 1974, states were effectively told by Washington that no new medical facilities could be built unless a “public need” had been demonstrated. The idea was to reduce costs, but the only measurable effect of this federal decree was a morass of bureaucratic red tape that stifled competition in the health care market.

And, like so many bad government ideas, the CON monster has been difficult to kill even after Washington tried to drive a stake through its heart:

In 1987, the federal statute was finally repealed, but many states inexplicably kept their CON processes in place. Alaska was one of them and, as Governor Palin put it in an editorial for the Anchorage Daily News, “Under our present Certificate of Need process, costs and needs don’t drive health-care choices — bureaucracy does. Our system is broken and expensive.”

The rest of the article can be read here.

As I have noted before, I have a rule of thumb that has served me well in assessing public figures and policy ideas: Anyone or anything Paul Krugman dislikes can’t be all bad.

So, when I saw that Krugman had trashed John Goodman about a (somewhat) tongue-in-cheek post he had written about abolishing the term “uninsured,” I knew Goodman must have made some worthy point. 

Goodman correctly points out that, like so many other terms used in today’s political and policy debates, “uninsured” has been rendered meaningless by misuse. Thus, he suggests dropping the misnomer:

Here is the idea: only people who are denied care are truly uninsured.  Everyone who gets care is effectively insured by some mechanism.  So instead of producing worthless statistics that people fling around in vacuous editorials and pointless debates, the Census Bureau should produce meaningful numbers, identifying all of the sources of funds people will draw on if they need medical care.

Krugman, with his trademark dishonesty, pretends not to understand what Goodman is getting at. Instead, he reduces the entire argument into one of his tired faux-progressive talking points:

Last week John Goodman, an influential figure in Republican health care circles, explained that we shouldn’t worry about the growing number of Americans without health insurance, because there’s no such thing as being uninsured. After all, you can always get treatment at an emergency room.

You would think that a guy like Krugman, who was once actually respected as an economist, could come up with some new material. But, alas, it is not to be. Instead we get “After all, you can …… zzzzzzzzzzzzz

In reality, Goodman’s post provides a pretty good blueprint for classifying “the uninsured” in a way that might actually be useful in clarifying the health care reform debate.

Not that Krugman and his fellow travelers are interested in clarity. 

I think John McCain has hit the ball out of the park with his VP choice.

Among the many assets the Alaska governor brings to the Republican ticket is a bias in favor of free market health care reform. Here’s a quote that captures her general position:

I support flexibility in government regulations that allow competition in health care that is needed, and is proven to be good for the consumer, which will drive down health care costs and reduce the need for government subsidies. I also support patients in their rightful demands to have access to full medical billing information.

And she puts her money where her mouth is. Earlier this year she proposed legislation that puts the above into actual practice in Alaska:

Palin last week introduced the Alaska Health Care Transparency Act to provide consumers with factual information on quality, cost and similar matters … At the same time, Palin is proposing elimination of the Alaska’s Certificate of Need process, likely to be much more controversial in health care circles.

Regular HCBS readers (Hi, Mom!) will remember that eliminating the Certificate of Need process is part of the Catron cure for health care, so it goes without saying that Governor Palin is right on this issue.

With Governor Palin on the Republican ticket, we can be pretty sure of having a free market advocate in the White House, even if McCain succombs to his age or war injuries while in office.

I’ve written before about Hillary’s penchant for prevarication. During her speech to the Democratic convention, Hillary told another of her trademark whoppers:

I will always remember the single mom who had adopted two kids with autism. She didn’t have any health insurance, and she discovered she had cancer. But she greeted me with her bald head painted with my name on it and asked me to fight for health care for her and her children.

James Taranto explains why one should doubt the veracity of this tale:

The trouble with this story is that cancer does not cause baldness. Cancer patients often lose their hair as a side effect of chemotherapy or radiation treatment. Unless this woman had alopecia unrelated to her cancer or was just making a fashion statement, she had health care.

God, I’m going to miss that woman.

According to the Census Bureau, the number of uninsured Americans declined significantly in 2007. As David Hogberg reports in Investor’s Business Daily:

The number of uninsured fell to 45.7 million last year from 47 million in 2006, largely due to expanded government coverage. That’s 15.3% of the population, down from 15.8%.

But the advocates of government-run health care are determined to see bad news in the report. They claim that the remaining 45.7 million need a government program:

That’s proof, liberals say, of a health care crisis. There is a case for growth in the safety net,” said Kathleen Stoll, deputy executive director of Families USA.

The problem with this reasoning becomes obvious when one looks at the makeup of the uninsured population. The following chart provides an eye-opening breakdown:

As the chart shows, nearly 10 million of the fabled uninsured are not actual Americans, and a large percentage make more than $50,000 a year. It’s not obvious that the voters want their taxes raised to cover such people.

But that’s exactly what advocates of government-run health care, including most of the people meeting in Denver this week, want to do. They believe universal coverage is a “moral imperative.”

And they ain’t talking about private coverage.

The other day I did a brief post about Michelle Obama and the contract that was awarded by her employer, the University of Chicago Medical Center, to one of her husband’s political cronies. I thought I was done with it, but the Blackwell deal gave off such a stench that I decided to do a longer piece. Here’s a taste:

The people who run the University of Chicago Medical Center may live to rue the day they hired Mrs. Obama. The Post story quotes a UCMC spokeswoman who says that the Senator’s wife “was not involved in the selection process,” and it may well be true that she didn’t put her hands on her hips, smite the floor with her expensive heel, and order cowering underlings to give the intranet project to her husband’s patron. Nonetheless, the Blackwell deal hardly passes the smell test, and CMS has a very sensitive nose.

Read the entire piece in the American Spectator.

Masochist that I am, I’ve been perusing the Dems 2008 draft platform. It’s really astonishing that they could get so many bad ideas into a single document. The one that caught my eye this morning was the call for an “end to to insurance discrimination”:

Health insurance plans should accept all applicants and be prohibited from charging different prices based on pre-existing conditions.

By using the term “discrimination,” the platform committee has couched this provision in the vernacular of “social justice,” but they’re really just rebranding an old regulatory boondoggle known as “guaranteed issue.”

A number of states have already enacted guaranteed-issue laws, and the end result is always a dramatic increase in premiums for everyone. Plus, as Michael New of the Heritage Foundation points out:

Many insurers quit offering insurance in states with guaranteed-issue laws, and the lack of competition results in still-higher prices and fewer choices for consumers.

Anyone think it’s a good idea to force the whole country to pay the huge insurance premiums now borne by the hapless residents of guaranteed-issue states like Massachusetts and New Jersey?

Well, a federal law ending “insurance discrimination” would produce that very result. 

By now, everyone who hasn’t been living on a desert island knows that traditional Medicare is headed for a fiscal meltdown. However, as I have pointed out before, there is a silver lining to the black cloud.

One segment of the Medicare program in which the market has been allowed to work, the prescription drug program, has been outperforming cost expectations since its inception. Grace-Marie Turner reports:

The Centers for Medicare and Medicaid Services reported that average beneficiary premiums for the standard Medicare drug benefit will increase by just $3 a month in 2009, to $28. That is 37% lower than the $44 a month that legislators estimated seniors would pay this year when the Medicare Modernization Act was enacted in 2003.

And Part-D is easier on the taxpayers than past projections suggested would be the case:

And the drug benefit, based upon consumer choice and competition, also is costing taxpayers less than expected: CMS says it will cost $46.4 billion in 2009 vs. $74 billion that had been estimated for this year.

And why is Part-D costing less than predicted while traditional Medicare is blowing the roof off of the most dire projections?

Competition works, even inside a public program, to give people more choices and keep costs down.

Amen.

That’s the conclusion Steffie Woolhandler, Benjamin Day, and David Himmelstein have reached. Why? Because Romneycare expanded coverage to everyone while making no serious adjustments to the other dynamics that affect cost. The inevitable result was a fiscal runaway train:

In sum, neither government, nor employers, nor the uninsured themselves have pockets deep enough to sustain coverage expansion in the face of rising costs.

Being single-payer zealots (they are founding members of the advocacy group PNHP), Woolhandler,  Day, and Himmelstein offer a predictable solution—-a wholesale government takeover of the health care finance system:

We remain convinced that more radical reforms can simultaneously expand coverage and control costs. A shift from our complex and fragmented payment system to a simple single-payer approach could save about 14.3% of total health spending …

Anyone who deals with our proto-single-payer system, Medicare, knows that it is anything but “simple.” In fact, its rules are so Byzantine that they fill 120,000 largely undeciperable pages. 

Arnold Kling has a much more sensible idea. Try the Woolhandler single-payer approach in a few states while simultaneously trying the free market approach in other states.

I would like to see [single-payer] tried, but only in some states. I would like to see other states try radical health reform of the opposite kind, with health insurance deregulated and major rollbacks of licensing requirements. Then we’ll see which performs better over the long term.

My bet is that Kling’s model would beat the stuffings out of the Woolhandler model. Meanwhile, it will be interesting to see if the “news” media and the “progressive” blogosphere continue to pretend Romneycare is a success. 

As I have said before, I believe the market provides the most efficient and humane mechanism for carrying out health care rationing. If you believe government bureaucracies can do a better job, I recommend this story in The Telegraph:

The NHS should not always attempt to save someone’s life if the cost is too much, the medical regulator has ruled.

Britain’s National Institute for Health and Clinical Guidelines (NICE) has recommended that the NHS abandon the ”rule of rescue,” which requires clinicians to treat dying patients without regard to cost. Why?

When there are limited resources for healthcare, applying the ‘rule of rescue’ may mean that other people will not be able to have the care or treatment they need.  

In making this ruling, by the way, NICE ignored the advice of its own Citizen’s Council, which insisted that “a rule of rescue was an essential mark of a humane society.” The NICE bureaucrats were not impressed:

Nice defended its ruling last night saying that the Citizens Council provided useful input to its decisions but that the organisation’s role was to determine how best to allocate the health service’s limited resources.

Giving the government control over health care spending—-whether you call the system socialized medicine, single-payer, or universal health care—-is to give them control over your life.

Think this sort of thing could never happen here? Read this.

Obamacare, as I have pointed out here and here, is a perfect storm of bad ideas. It is, however, downright sensible compared to his plan to address high gasoline prices. Here’s Don Boudreaux at Cafe Hayek:

Barack Obama proposes to deal with rising gasoline prices by giving a $1,000 “emergency rebate” to consumers - a rebate to be paid for by taxing the so-called “windfall profits” of oil producers.

If it isn’t obvious why this is an extraordinarily dumb idea, Boudreaux explains:

This plan - which increases the demand for gasoline and reduces its supply - makes as much sense as trying to put out a fire by dowsing it with jet fuel.

That Obama’s plan will result in higher gas prices may not matter, however, because his plan to impose health care mandates on businesses will eliminate many of the jobs to which people now drive their cars.

A while back, I asked this rhetorical question: Why wasn’t Edward Kennedy flown to Europe to have his cancer treated? The answer, of course, is that the much-maligned U.S. health care system is the best in the world.

Nowhere is this more obvious than in the area of cancer treatment. John Goodman reports on another study published in Lancet Oncology showing that the U.S. has the best cancer survival rates:

A new study of cancer survival on five continents lays to rest the theory that Americans fare poorly compared to other developed countries … in almost every category Americans survive cancer at higher rates than patients in other developed countries.

Here’s a chart showing U.S. survival rates for breast and prostate cancer compared to the survival rates of four countries whose health care systems are often touted as superior to ours:

Wait a minute. How can the U.S. have better survival rates than France? Wasn’t the French system rated the best on the planet by the World Health Organization?

And what the hell are Norway’s survival rates doing so far behind those of the United States? According to WHO, the Norwegian health care system is WAY better than ours.

Hmm. Anyone care to guess where rich Frogs and Norwegians go to get health care care when they are really sick?

Last week, at an event hosted by the Center for American Progress Action Fund, one of John McCain’s health care advisors (Al Hubbard) pointed out the following:

When a third-party pays for a service or product—we consume it as if it was free…It’s interesting, if you would think about, the employers rather than providing health care insurance they provided food insurance. So every time you go to the grocery store you just take out your food insurance card, you give it to the cashier, she scans it, and you’re outta there. Pretty soon, you would start buying caviar, expensive steak, and you start buying more than you need …

For anyone acquainted with basic economics, Hubbard’s assertion is unremarkable. It is blindingly obvious that if consumers are insulated from the cost of something, they will consume more of it than they need.

But there are soi-disant health care wonks out there who remain stunningly ignorant of economics. Thus, we get this post, in which Ezra Klein fancies himself outing a ”revealing slip”: 

Caviar and oysters … are luxury goods, sensual pleasures that we love to experience when finances permit, but understand we can do without when incomes tighten … By contrast, colonoscopies and MRIs aren’t a good time … Diagnostic tests and medical treatments are not luxury goods.

One would think that even a guy with Klein’s limitations could see that the man wasn’t saying MRIs are “sensual pleasures.” Even dumber is Klein’s assertion about medical decision making:

Hubbard characterizes the purchase of medical tests as “our decisions,” but that’s inaccurate. They are our doctor’s decisions. We don’t want to make those purchases; we’re informed that we need to make them. Then we try and figure out how to pay for them.

It is clear that Klein cannot imagine patients as autonomous entities capable of critical thinking. In this he has a lot of company among “progressives.” They are wrong. These are indeed “our decisions.”

Take Klein’s colonoscopies, for example. They are routinely recommended by PCPs for all patients older than 50. It’s a precaution. There is no reason that you can’t say “Nah, I’ll do it on the next check up.”

Refusing to do the routine colonoscopy does involve a tiny risk, but so does driving an automobile.  And, as adults, we have the right to take that chance, particularly if we must write a check for the procedure.

Under our current (hopelessly perverse) third-party payment system, it never occurs to most people to say “no.” Why? Because, as Hubbard correctly points out, the colonoscopy seems “free.”

Most medical decisions are not urgent. Hubbard’s only point is that, in a system that required us to write a check for medical services, we would be more circumspect about how much we consume.

Is that really so hard to absorb?

The primary difference between those who promote market-based health care reform and the people who prefer a government-imposed solution is their respective opinions of the customer’s intelligence.

The former believe that patients are capable of critical thinking while the latter think we are too dumb to know what’s good for us. An excellent example of the patients-are-dumb view can be found at Health Beat:

85 percent of Americans report being satisfied with the quality of care they receive—despite the fact that patients get, on average, just 55 percent of the care that experts recommend for most major medical conditions.

For the post’s author, Niko Karvounis, the huge number of satisfied patients is not a sign that the system works reasonably well despite its flaws. It is, instead, proof that patient opinion should be ignored.

The lesson here is clear: if you really want to improve health care in the U.S., you need to look beyond superficial preferences and into the nitty-gritty of how health care is delivered in our system.  

In other words, disregard the ”superficial preferences” of the customers and give them what the “experts” say they should have. This is seriously patronizing stuff.

And it gets worse. This post gets truly creepy when the purpose of polls is discussed. Karvounis apparently thinks “getting polling right” means using public opinion surveys as re-education tools:

Clearly we can’t expect polls to be the only—or even the central—way of educating the public on the relationship between care delivery and cost. But they could do a much better job at exploring if and how the public understands this relationship.

Er … Niko … the purpose of public opinion polls involves measurement. Legitimate enterprises use them to gauge public preferences so that products and services can be tailored to consumer needs.

Illegitimate enterprises use polls to manipulate public opinion so that shoddy merchandise (e.g. government-run health care) can be shoved down the customer’s throat.

Health care reform that ignores the opinions of the patients will produce a health care delivery system that will make our current system look like a Swiss watch by comparison.

Americans understand this, so Karvounis (and many other advocates of government-run health  care) conclude that the hoi polloi just don’t get it. But the people are smarter than they think.