Big Mommy Is Watching You!
Today's Must Read: Ezra Klein: Health Care Is Not a Negotiation But a Campaign - The Liberal Revolt

Say It Ain't So, Steve (Pearlstein, That Is)

After a good run, the sharp-eyed and highly intelligent Steve Pearlstein succumbs to the standard Washington Post he said-she said opinions-of-the-shape-of-earth-differ journamalism:

Steven Pearlstein: The public option has become for the left what "death panels" have become for the right -- an easily understood metaphor that can be used to wage an ideological war over the issue of Big Government, and mostly a sideshow...

I don't know what it is about the water in the Washington Post building, Steve. But get out of there now: you are (or you ought to be) a lot better than that. The public plan is not the left-wing equivalent of the right-wing death panel craziness.

Indeed, you also write:

[O]ur system of private health care and health insurance has not been effective in restraining the growth of medical expenditures.... [P]rice competition in our private markets is something less than robust.... [C]onsumers don't... shop around for bargains the way they do for cars or toilet paper... many regions of the country have dominant hospital chains that can virtually dictate rates.... You simply could not offer a competitive insurance product in Northern Virginia, for example, if Inova's Fairfax Hospital weren't in your network. And in many rural communities, there's only one hospital. Drug companies have monopoly pricing power.... Ditto for medical-equipment makers.... One goal of health-care reform is to begin to address these market imperfections.... You also hear the argument that government-run insurance would have lower costs because... Medicare... spends about 2 to 3 percent of its budget on administration [instead of 30]...

That's right, Steve. And that's why having a public plan would add to health insurance companies' incentives to work harder on lowering their own costs, and increase price competition. And a public plan that wasn't in the business of spending lots of its money figuring out how not to cover sick people would have lower administrative costs. Enough lower to make it a viable large-scale player in the market? We don't know. A public plan would let us see.

Some bills without a public plan would still be worth passing. Some bills with a public plan would not be worth passing. But a public plan is not merely an "easily understood metaphor that can be used to wage an ideological war." A public plan would be a pro-competitive intervention in the health care market.

And if it turned out that it could provide better care at lower costs than private insurers, and if people did flock to it, and if it did become the plan a plurality or a majority of Americans chose--would that be so bad?

That's very different from the insane screaming about how people shouldn't think about whether they want an advance medical care directive and what it should say.

Why oh why can't we have a better press corps?