Avik Roy was on Up with Chris Hayes this morning. He is something of a healthcare expert. But you know what “expert” means when it comes to a conservative: effective apologist for the status quo. And he didn’t miss a beat this morning. He started right out cherry picking studies that showed that having Medicaid is worse than having no insurance at all. Hooray for the broken US healthcare system!
The problem, of course, is that Roy and his corporate friends don’t think, “Medicaid has problems, let’s fix it!” Instead, it is, “Medicaid has problems, let’s kill it!” This is what you get when your guiding philosophy is that the poor are morally repellent and so should just be allowed to die. (This is not an unfair characterization. Conservatives want the poor to just go away. I’m not suggesting they want to do it with a gun. But depriving them of healthcare is the same result by different means.)
Last week, Roy and Douglas Holtz-Eakin wrote an article for Reuters, The Future of Free-Market Healthcare. In it, they claim that maybe Obamacare isn’t that bad, but they would like to make some changes that will make it truly a free-market system. And so they pull out Switzerland and claim that we should be more like them.
Aaron Carroll, the medical economist, took them to task on this argument. He concludes, “I don’t think the Swiss health care system is what they think it is.” They claim that the Swiss system is better because it doesn’t have a public option. This doesn’t make any sense at all. First: neither does the United States! How does that make it more free-market than America? What’s more, Carroll points out that they are wrong on this point even still. The Swiss system requires private insurance companies to provide non-profit healthcare products. In other words, “Yeah, they effectively have a public option.”
Next, the dynamic duo claims that the Obamacare state exchanges are terrible because they are “larded with costly mandates and regulations.” Carroll really doesn’t like this bit of chicanery:
There are other problems. But the biggest problem is their claim that the Swiss healthcare system is cheaper than the American system because—Wait for it!—it is more free-market. Carroll points out that it is cheaper because doctors get paid about half as much there. On top of this, Paul Krugman reported that they were greatly underestimating the cost of the Swiss System, because so much of it is private. This is an old conservative claim: if we don’t pay for Medicaid, we’ll save money! Well, the government will save money; the country will end up paying far more.
Look at the following graph from Krugman’s first article about the Holtz-Eakin and Roy paper:
Do you notice something interesting in this chart? The only country that pays more for their healthcare than Switzerland is the United States. And despite this, Switzerland is ranked 20th by the WHO.
Take a moment to think about this. Avik Roy and all his pals are committed to a particular form of healthcare. What works well is not the issue at all. The only thing that matters is to keep corporate profits high. Note: this isn’t about giving the rich the best healthcare available. They will always have that. Even in countries like France, the rich can still buy private insurance. The problem from the standpoint of Roy is that all his buddies might make a few dollars less. And when you compare a couple of dollars in profit for the already wealthy to tens of millions of people without access to healthcare, the conservative answer is clear: the dollars matter far more than the people. Because, hey, the people are poor; they don’t matter at all.
Update (23 February 2013 4:12 pm)
In the segment Now We Know, Avik Roy talks about how even with Obamacare there will be 30 million people without healthcare. As I recall, it is now looking like it will be a lot less than that. The main problem is that there will be a lot of people who will qualify for it, but won’t know it. Regardless, when Roy said that, he seemed like he was going to burst out laughing. I often have conversations with conservatives who now complain that Obamacare is (1) too complicated and (2) non-universal. This is rich! It is exactly because of conservatives like Avik Roy that we have a system that is (1) too complicated and (2) non-universal. At this point, it seems that Roy is thrilled that his dastardly plan worked so that he now has a “multi-year project for us to try to make the case to conservatives that actually universal coverage is the path to getting our fiscal ship in balance.” I’m sure it will be very lucrative at the same time it won’t provide a single person with healthcare.