The Devil We Know

Conor Friedersdorf lists three reasons to fix the problems in the health care system and three major concerns about the legislation being proposed to fix it.

I am convinced of the need for major reform in the health care sector, especially due to three arguments.

a) The current system is an economic drag insofar as it ties people to jobs they'd otherwise leave, discourages entrepreneurship, and otherwise lessens healthy risk-taking because people fear losing their insurance.

b) There is a moral obligation to ensure that every citizen has some minimum level of health care, in the same way that society has decided everyone should have some baseline level of food. I find it difficult to pinpoint what level exactly, but I suspect we're currently falling short of it.

c) I suspect the government can play a useful role pushing measures like electronic medical records that I doubt would happen absent a state coordinating role (including privacy protection measures). I'd be curious to hear the best arguments against those propositions.

I am skeptical that I'll be able to support the plan progressives intend to put forth. This is due to three concerns.

a) Its cost. I'd bet a hefty sum that expanding coverage and the role the federal government plays in health care is going to significantly increase rather than decrease costs. Since we're already paying for costly foreign wars, generations of accumulated debt, a massive bailout, and other entitlements with rapidly rising costs, it doesn't seem like we're in a fiscal position to pile on more government spending.

b) Fear of excessive state power. It shouldn't be too difficult to imagine another Dick Cheney or Richard Nixon in the White House. Are we really comfortable assuming that the state will never use its role in health care to pressure political opponents, or collect frightening kinds of data, or politicize medical decisions more than is now the case? Isn't there any size and scope of government that progressives deem to be too big on prudential grounds? Why doesn't this put us there? Isn't it better for one among many health insurance companies to deny coverage, compared to one government run entity deeming something uncovered, as could happen if a public option drove some or most insurers out of the market? Health care is really important. Isn't it unwise to concentrate too much power over it in any one place, the federal government included?

c) Fear of lost innovation. I keep seeing the argument that America is the leading health care innovator, and that if our system looks more like what Europe has, there won't be anyone left making strides in research and development. I haven't seen a convincing rebuttal, though there may well be one. Links?

I agree with both principal points: the current system is deeply flawed, yet, based on the government's recent performance in the comparatively simpler task of reviving the economy, have no confidence that the cure will be better than the disease.