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August 25, 2006

It's All Relative

It's probably inevitable, but this sort of thing irritates me. From The Economist's review of Bruce Reed and Big Ideas Emanuel's The Plan: Big Ideas for America:

If the system is made more efficient, Mr Emanuel thinks coverage can be extended to all American children. But he concedes that a nation as individualistic as America will probably never accept a European-style national health service—and he should know, having worked on Hillary Clinton's doomed health project in the 1990s. He argues, however, that maybe, some day, every American might receive a voucher for basic health services from the insurer of his or her choice.

How interesting -- Emanuel dismisses the chances for a universal health system, but leaves open the option for an absurdly complicated voucher scheme, precisely the sort offered up by his brother, the bioethicist Ezekiel Emanuel, in The Washington Monthly awhile back (which I took on here). All those who occasionally speculate about Emanuel's fitness for Speaker of the House should take this statement very seriously: He does not believe in any sort of coherent national health care system. On the bright side, his family values seem strong.

Incidentally, I've flipped through The Plan a bit, and I doubt I've ever seen a book with a subtitle so deeply misleading. This is warmed over, second term Clintonism at its incrementialist. I'm one of six people in this country who get excited over policy papers and even I wanted to cry. The typical chapter would mention an awesome Big Idea, then decide it's politically unfeasible, and promise to push 1/10th the policy but with More! Awesome! Market! Mechanisms!

Emanuel Family Fun Fact: Did you know the third Emmanuel brother is Hollywood super agent Ari Emanuel, also known as the inspiration for Ari Gold on Entourage?

Crossposted at Tapped

August 25, 2006 | Permalink


well that explains why clinton was on charlie rose the other night supporting this book

Posted by: akaison | Aug 25, 2006 3:39:33 PM

The Economist surely knows better than to think that a voucher system that does not use the buying power of a single payer to hold costs down will certainly end up accelerating health cost inflation. Indeed, they themselves are certainly able to come up with a better universal access US-government subsidised system than the voucher system, based around a competitive market for insurance plans to provide a standard array of coverage, no insurer allowed to overlap that coverage to cherry pick, and no insurer allowed to operated in a state without offering the standard package to all comers in the state.

And the Economist is certainly being a bit dishonest in terms of saying that American's won't accept a UK style health service. After all, more Americans will accept a Canadian style single-payer system than a single-provider system ... but they use loose language that allows single provider systems to be treated as if they were the benchmark.

So, in other words, there are corporate interests that do not want universal health insurence in the US that uses the buying power of a single buyer, do not want market reform that forced them to engage in full fledged competition rather than cherry picking and price discrimination, and do not mind having government subsidizing health care price inflation.

Not at all surprising, but certainly points to keep in mind regarding where the attacks and diversionary efforts are going to come from in the fight for universal health care.

Posted by: BruceMcF | Aug 25, 2006 3:45:25 PM

Ouch, I should not let The Economist get under my skin so bad that I fail to write grammatically coherent sentences.

A voucher system that does not use the buying power of a single payer to hold costs down will certainly end up accelerating health cost inflation. And The Economist surely knows better than to think otherwise.

Posted by: BruceMcF | Aug 25, 2006 3:48:04 PM

"second term Clintonism at its incrementialist"

Is that supposed to be an insult?

Posted by: ostap | Aug 25, 2006 3:50:29 PM


Posted by: Ezra | Aug 25, 2006 3:58:11 PM

Ezra, did you really expect anything else from that writing team? Seriously now.

Posted by: paperwight | Aug 25, 2006 4:32:58 PM

Ari Emmanuel? Big deal. I'll be impressed when you tell me somebody's brother is the inspiration for Al Swearengen.

Or, hell--I'd settle for Roman Grant.

Posted by: Tom Hilton | Aug 25, 2006 5:32:29 PM

Ari gets props from me for this....

After Mel Gibson's recent, um, indiscretion, there was much handwringing and speculation about how we should deal with this and what a horrible event it all was... but nobody said word one about not doing business with the guy. Ari, contrary to his Ari Gold charicature, was first to the post to say, hey, howzabout we stop doing business with the scumbag, hm? Yeah, you might make a few bucks, but good lord, people, strap on a pair and make a stand.

So, essentially, while all Hollywood was hoping that it would all blow over so they could go back to making money with Mel, Ari showed more cojones than Rahm has ever shown anywhere about anything, ever.

Posted by: collin | Aug 25, 2006 6:17:44 PM

Shouldn't that be "incrementalistist"?

Posted by: apantomimehorse | Aug 25, 2006 7:44:14 PM

Ari is the one. Rahm will always be teh lame.

Posted by: fasteddie | Aug 25, 2006 9:54:01 PM

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