Health Policy Death Match: Klein vs. Ponnuru
I count both Ramesh Ponnuru and Ezra Klein as friends. (I’m so post-partisan.) Why, oh why must they force me to choose between them??
Ponnuru had an op-ed in yesterday’s New York Times where he reaffirmed his membership in the Anti-Universal Coverage Club. Klein responded in a way that’s sure to satisfy his base, but I think he left the reality-based community wanting. Are you ready for the fisk?
Klein suggests that if “80+ percent of Americans . . . think the system needs fundamental changes or a complete rebuild,” then 80+ percent of Americans must support universal coverage. Hmmm, bit of a stretch. In fact, I can recall one poll where nearly one-third of likely Democratic primary voters rejected universal coverage.
Klein suggests that giving consumers the freedom to avoid unwanted state health insurance regulations would mean that Arizonans wouldn’t get coverage for colorectal cancer screening, and that there would be no mammogram coverage in Idaho. Mmm, that’s good crazy. I refer my right honorable friend to the episode where The New Republic‘s Jonathan Cohn made a similar claim about mandates for prostate and cervical cancer screening. I looked up the services covered by the plans made available to the Cohn family by the University of Michigan. It turned out that six out of the seven available plans cover both prostate and cervical cancer screening — even though Michigan requires insurers to cover neither. (I offered to wager Cohn a fancy dinner that his family has coverage for both, but I never heard back from him. Foolish, really, to let me know where he gets his insurance. Klein would never give me such an opening . . . or would he?) What Ponnuru proposes is to let Arizonans and Idahoans and everyone else choose what their health plan covers. Imagine that: people rationing medical care according to their preferences, rather than the preferences of employers, interest groups, bureaucrats, health policy wonks… Why Klein clings to such regulations despite zero evidence that they actually increase access to the targeted services is beyond me.
Klein criticizes Ponnuru for proposing to replace the current tax preference for job-based coverage with a tax credit available to everyone, much like John McCain proposed during his (latest) presidential campaign. Ponnuru cites a study estimating that tax credits would reduce the number of uninsured by 20 million. Klein counter-cites one study estimating that tax credits would have zero net effect on the number of uninsured, and a second study estimating that those who transition from job-based coverage to the “individual” or “non-group” market would pay an additional $2,000 per year for an identical policy. Klein’s criticisms sound persuasive — provided you know precious little about the topic. For one thing, the two studies Klein cites are actually the same study. Pity, really. Had Klein found a second study to support his position, perhaps it would not have been quite so flawed as the one he did find. Here’s what I wrote back in September about that study’s flaws:
The Bloom Could Not Survive
“Among several outstanding nominations made by President-elect Obama, I believe Arne Duncan is the best.”
That’s what Senator Lamar Alexander (R-TN) said of now-U.S. Secretary of Education Arne Duncan at his confirmation hearing. Alexander thought that Duncan was a man who truly embraced reform and could work with anybody, and who, like his boss, seemed to really want to get beyond politics.
That was before reality set in.
With the Department of Education’s media-dodging, Friday-afternoon release of a study showing that Washington’s voucher program is outperforming DC public schools at a fraction of the cost, and Duncan’s galling failure to report these results as Congress debated the voucher program’s fate last month, it has become clear that Duncan is far from above playing politics. Of course, he isn’t necessarily calling the shots. He works for President Obama, whom you might recall announced that his children would attend posh, private, Sidwell Friends on a Friday afternoon.
It’s not only on choice that Obama and Duncan are playing the game. They are great at reform-y talk about such things as accountability and high standards, but talk is all they’ve delivered. Oh, that and tens-of-billions of dollars to bail out public schools from which parents should never be allowed to take their kids and money, and which aren’t good enough for the president’s children.
So is the public starting to see that the administration might not be delivering the great change it has promised? It’s hard to tell, but some journalists and education wonks are catching on.
Not-so-COOL Rules Stoke Xenophobia
Come Monday you can thank the federal government for making food more expensive by requiring retailers to provide useless information.
On March 16, federal regulations will finally kick in that require perishable food at the grocery store to sport “country of origin labeling,” known as COOL. The rules were originally passed by Congress as part of the 2002 farm bill, but are only being implemented now because of understandable resistance from retailers.
The COOL regulations will require that all perishable food products be labeled at retail to indicate the country of origin. The regulations cover beef, pork, lamb, goat, chicken; wild and farm-raised fish and shellfish; fresh and frozen fruits and vegetables; peanuts, pecans, macadamia nuts, and ginseng.
In a recent statement announcing final implementation, Obama administration agriculture secretary Tom Vilsack said, “I strongly support Country of Origin Labeling — it’s a critical step toward providing consumers with additional information about the origin of their food.”
This is nothing but a form of regulatory harassment designed to play to anti-foreign prejudices. COOL provides zero health or safety information; foreign meat and produce must conform to exactly the same health and safety standards that apply to domestic-made goods.
Obama Administration Agrees with Cato on Auto Fuel Efficiency
Well, sort of. The Obama administration signaled last week their belief that it would be better to have one national fuel efficiency standard than a multiplicity of different state fuel efficiency standards. Now, we have long maintained that fuel efficiency standards — federal or state — are a bad idea. Consumers should be free to buy whatever sort of car they want without government economic coercion. But if we must do violence to consumer sovereignty, better to do so via one national standard rather than via a hodge-podge of differing state standards.
This is the very argument I made late in January over at The New York Times when asked about California’s petition to establish its own fuel efficiency standard as a means of addressing greenhouse gas emissions. Alas, I was pilloried on the NYT comments board at that time for all sorts of sins against man and nature. Now it appears that President Obama has come over to the dark side. Welcome to my world, Mr. President.
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