A Strange, and Possibly Terrible, Case Against Health-Care Reform

It's a bit hard to know where to start with the Wall Street Journal's long argument against health care reform. Our health care system, they argue, is worth the money we pay for it. It is a dazzling achievement, ensuring not only longer lives, but better lives. The problem with the Obama administration's health care plans? They want to extend those benefits to those who can't currently afford them.

Reform would be perfectly acceptable if it was "merely trying to defossilize Medicare and save the federal fisc," says the Journal. The problem comes elsewhere: The attempt to "pass the largest entitlement expansion since 1965."

This, the Journal argues, will prove unaffordable. It will make our health care system too expensive. This country -- the richest on earth -- cannot foot the bill for universal health care. But that, of course, is untrue. Even a high cost estimate -- $120 billion in 2010, say -- is not that large in the scheme of the federal treasury. It's not much larger, for instance, than the outlays directed towards the Iraq War, which the Journal enthusiastically supported. It's certainly nothing that can't be raised with the imposition of some new taxes, as the seventh graph on this page neatly shows.

Rather, the Journal is arguing that we should not spend that money on universal health care. It is an audacious argument. Elsewhere in the editorial, the Journal commends a study by David Cutler and Mark McClellan that found the benefits of lower infant mortality and advances in the treatment of heart attacks "have been sufficiently great that they alone are about equal to the entire cost increase for medical care over time."

The study itself can be found here. Here's a part that the Journal does not quote: "Only one truly new therapy—angioplasty with stent—was developed in this time period," write Cutler and McClellan in their section on heart attacks. "Rather, technological change is predominantly the extension of existing technologies to more patients."

In other words, the great gifts of our health system -- the very benefits upon which the Journal bases its claims -- come primarily from the extension of health services to more Americans. It comes, in other words, from the very part of health reform that the Journal opposes.

I can imagine an argument against health-care reform that runs something like this: Our health care-system is inefficient and ineffective. Funneling money into the coffers of hospitals will not sufficiently improve the health of the nation. Those dollars should go toward early childhood education or subsidies for fruits and vegetables, or, if you're a simple utilitarian, treatments for third-world malaria.

What is unimaginable to me is an argument that goes like this: Our health-care system is worth the expense. It makes the lives of those it touches better and longer. The price per person is worth it. But we should nevertheless refuse to pay it for the poor or the sick. It is like an early car enthusiast's case against the Model T.

Yet that is exactly what the Journal has argued.

Their fear, it seems, is that the expense of health care will foretell the nationalization of health care. "Almost all care will be rationed by politics," they warn. But what does that even mean? That society will decide the amount of money it wants to spend on health care and then choose how best to allocate those resources? And it's not even as if the Journal's editorial board is against deciding what is, and is not, worth taxpayer dollars in theory. They would simply prefer that such decisions were left to them.

(Photo credit: AP Photo/Emilio Morenatti)