Thought Rationing

by Jonathan Chait | July 15, 2009

Two weeks ago, President Obama offered to cut several hundred billion more dollars out of the Medicare and Medicaid budget to help make room for health care reform. This sort of gesture ought to appeal to conservatives, right? Apparently not. The Heritage Foundation warned, "At a time when Medicare is dangerously close to bankruptcy, it is shortsighted to funnel funds into the creation of another government-run program instead of shoring up Medicare." A National Review editorial complained, "These cuts in Medicare and Medicaid payments are nothing more than reimbursement reductions with no empirical or economic basis to justify them."

No empirical basis to justify them? Since when do conservatives require an empirical basis to justify cutting social spending?

The health care debate has been presented as a conflict between spendthrift Democrats and skinflint Republicans. The reality is closer to the opposite. Conservatives may make up the strongest opponents of new government spending (to cover the uninsured), but they also make up the strongest opponents of cutting existing spending. Health care has become the new defense spending--a category of public outlay that the right has trained itself to defend in even the most wasteful iterations.

The U.S. health care system, as you probably realize, is a vast cesspool of waste. We spend nearly twice as much on health care as the average advanced country and have no better results to show for it. Alas, every dollar of what we call waste is what somebody in the industry calls "income." So anything that makes the system more efficient makes somebody unhappy, and that somebody has a team of lobbyists.

Watch senior editor Jonathan Chait discuss this article with editor Franklin Foer:

 

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