Strong opinions, weakly held

The two sides of health care reform

James Surowiecki ably describes the gulf between Democrats and Republicans on expanding access to health care. Democrats see the fact that 50 million Americans don’t have health insurance as a problem that the federal government should solve in the near term, and Republicans don’t. Democrats also see the fact that for certain groups of people, it’s impossible to get affordable health insurance at all as an individual as a problem, and the Republicans don’t. Or at least they don’t see either of those problems as being worth doing what it takes to solve them.

But there’s another side of the issue that he completely ignores — the fact that health care costs are rising rapidly and that both Medicare and employer-funded health insurance are headed for disaster. Most retiree health plans are already in deep trouble, and the second order effects are severe. One of the reasons General Motors has been uncompetitive is that a substantial portion of the revenue they earn from each car they make goes to pay for health insurance for retired autoworkers. Republicans do not seem to want to engage on this issue, even if America’s system were perfect today, the rising costs insure that it’s going to have big problems down the road.

And this, to me, is the bigger problem. Republicans and Democrats can debate until the end of the world whether the government should make sure everyone has health insurance. I am strongly in favor of universal health care, personally. But regardless of where people stand on that issue, our government is going to have to engage with the issue of rising health care costs and growing Medicare enrollment sometime soon. The fact that Republicans are unwilling to treat the problem as the impending crisis that it is disqualifies them from being taken seriously as far as I’m concerned.


  1. It’s not just health care, it’s also the hyper-inflated prices of prescription drugs. The pharmaceutical companies claim the prices are high because they nee ro recoup the costs of R&D and marketing, but if that were completely true then why are these same drugs available for a fraction of the cost in other parts of the world?

    If anything, the government needs to regulate the pricing structure of prescription drugs so that Americans are paying a fair price.

  2. Prescription drugs are cheaper in other countries because their governments negotiate a single price for the whole country. Our government obviously doesn’t do that, and doing so was not included in this effort because, I assume, the White House felt that having the drug companies on the other side would kill the bill entirely.

  3. The companies do have to have a legitimate need to recoup their R&D costs (it is expensive to develop new drugs, and not all R&D efforts result in a marketable drug), but because the other countries negotiate prices the US is essentially subsidizing the cost for the rest of the world.

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