Who can you trust?

I just finished reading Ezra Klein's chat transcript today (if you are a liberal with concerns about health care reform you really should read it– he addresses most all the concerns quite thoroughly).  Towards the beginning he makes a really good point:

I want to be very clear on this: I think this bill will do more to
help the poor and underserved than anything since the Great Society. I
think it will do more to control costs, and create an infrastructure to
control costs and a politics able to control costs, than anything we've
ever done, full stop.

I'm not alone in this. Writers like Jon Cohn. Advocates like the
Center for Budget and Policy Priorities and Families USA. Senators like
Jay Rockefeller. Among the people who have really been in the trenches
on this for years, there's near unanimity that losing this bill will
be, and will come to be understood, as one of the most tragic and
unnecessary failures in recent legislative history.

I've been a health policy junkie for years now and the truth is guys like Ezra Klein, Jon Cohn, and others have been writing about and demonstrating a huge depth of understanding to these issue for years.  Now liberals are supposed to turn against it because Daily Kos, Glenn Greenwald (whom I love on civil liberties, but is out of his depth on health care), Howard Dean (being a doctor is not at all the same as understanding health policy), are complaining.  What did these guys have to say about health policy two years ago– probably nothing.  The people who have been deeply involved in this policy area for years and whom understand it the best are those most strongly advocating that we need to pass this (admittedly imperfect) legislation– that should tell you something. 

 

It’s the providers stupid (and I do mean stupid)

I like to think that liberals are generally smarter, appreciate more nuanced thinking, and are less paranoid than conservatives.  Actually, I still do think that, but damn if the liberal fringe isn't doing their best to disprove all that lately.  They've come out in force in the comments of all my favorite bloggers (e.g., Drum, Klein, Yglesias, Cohn) who have been arguing smartly and strenuously that the current health reform, though lacking, will be a huge net positive.  The latest liberal bugaboo is the individual mandate that requires individuals to buy insurance.  Apparently, they believe we shouldn't require people to buy something from only private companies (hello, auto insurance?).  As anybody who gets health policy will tell you, the whole system of near-universal coverage falls apart without an individual mandate and costs go way up for those who actually do have insurance (Great explanation by Ezra). 

One thing that is clear to me in reading all the comments from enraged liberals, is that very few have a meaningful grasp of the fundamental problems with the health care system in this country.  All they want to do is blame the for-profit insurance companies.  They are certainly part of the problem, but the truth is that the providers, especially hospital networks, have huge leverage and are able to charge prices far out of line with the rest of the world.  (Here's a very nice explanation in a health policy journal, also check out this great podcast from This American Life).  The Senate legislation is attempting a number of features to try and address this problem.  (Check out Atul Gawande on the matter).  Yes, for-profit insurance companies can be very evil, but the legislation quite pointedly addresses the worst of these evils.  Real cost control ultimately depends on addressing the prices providers charge– a strong public option (never going to pass) would be great for that, but the key is not whether we go through for-profit or public insurance, but that we find a way to keep these provider costs down. 

King of Wolfblogs?

So, I thought I'd do a little blogging from the public library (I came here to grade and save myself a 30-minute round trip before heading back to Evan's pre-school for his Christmas concert in) and since Wolfblogs is not bookmarked here, of course, I just googled "wolfblogs."  As on many sites, the most popular subpages show up immediately under the main link.  In this case, "Getting Started," "Information for faculty," "Examples," and yes, right along with all those, this very blog, "shgreene."  I would be a nobody on blogspot, but at least I'm a somebody on Wolfblogs .