I have a lot of respect and admiration for Zeke Emanuel. I really, really do. But when I read his Opinionator piece this weekend, I went away a little annoyed:
WHEN it comes to health care, most liberals are committed above all to ensuring that every American has insurance. In their view, the greatest achievement of the health care reform act passed under President Obama is to finally erase the moral stain of the United States’ being the only major developed country without universal coverage. But we also hold the questionable distinction of having the world’s most expensive health care system — what about cost control? For many liberals, that just sounds like a cover for heartless conservatives who care only about cutting benefits and not about helping people in need.
But liberals are wrong to ignore costs. The more we spend on health care, the less we can spend on other things we value. If liberals care about middle-class salaries, public education and other state-funded services, then they need to care about controlling health care costs every bit as much as conservatives do.
Who are these liberals who “ignore costs”? I will bet all the money in my pocket right now that when President Obama gives the State of the Union speech next week he devotes massive amounts of time to reducing spending. When the ACA was passed, it did not contain all the cost-controls I’d like, but it did contain more than any other recently passed legislation. I hear liberals talk about “bending the curve” so much I think it’s lost meaning.
I also think that most of the “liberal” experts talk about this all the time. Find me a single well-respected wonk in the blogosphere who isn’t concerned about costs. I did a two week series on health care costs!
It makes for an interesting straw man, but I think Emanuel is making the wrong argument by arguing against these cost-ignorant liberals. It isn’t that conservatives want to cut costs and liberals don’t. It’s that they want to do it in different ways. Conservatives usually* want to rely on the market and individuals (those at the bottom of the health care system) to be responsible for driving costs down. Liberals usually* want to rely on experts and government (those at the top of the health care system) to be responsible for driving costs down. We can debate those competing schools of thought, and how they might or might not work, without resorting to believing that only one side cares.
On a side note, explain to me how Medicare Part D – passed by a “conservative” government – controls costs at all.
*Note that exceptions abound, and this is an overly simplistic description. I think the broad brush strokes are pretty accurate, though.
[Cross-posted at The Incidental Economist]