Fred Hiatt Should Read the Health Care Bills

Weird column today by Fred Hiatt.

First he criticizes the Democrats for not trying to tax employer-provided insurance plans, but he doesn't mention the phrase excise tax. That is weird, because the excise tax in the Senate Finance bill is a tax on employer-provided insurance plans. Hiatt is permitted to think the tax is too small, or unlikely to survive a vote, or likely cause popular backlash. But he's not permitted to write as though it doesn't exist.



Second he criticizes the Democrats for not trying to regulate the "minutiae" of Medicare, even though the bills in Congress include comparative effectiveness research; expand on the billions Obama spent on electronic records in the stimulus bill; start an "innovation center" fund to test ways to move away from costly fee-for-service; and institute MedPAC, the independent advisory counsel that will try to make difficult decisions Medicare delivery and payments.

It's practically identical to Robert Samuelson's article one month ago that also reads like Samuelson has never read any of the Democrats' bills. To be clear, criticisms about cost control via employer benefit reforms and delivery systems are important, but by refusing to mention basic ingredients in the reform bills, these pieces are strangely divorced from reality.

Also, I don't like this at all:

Single-payer national health insurance may be the best outcome, but we should get there after an honest debate, not through the back door.

"After an honest debate" has my vote for worst phrase in political commentary because it is so fundamentally dishonest and meaningless. First of all, we've been debating health care for half a year now. WaPo's exhortations notwithstanding, I guess this is as honest as it gets.

More broadly, commentators are only in love with honest debates when they need cover. Otherwise, they love declarations. The GOP didn't ask for a supply-side symposium in 2001, they just wanted lower taxes. Gay rights activists don't want a Socratic inquiry into their beliefs, they want their damn rights. If Hiatt thinks single-payer national health insurance is really the best health care system, then I'm not sure why he'd be willing to sacrifice it up to the talking heads on cable news and morning talk shows. Generally speaking, it's ludicrous to crucify good public policy for the sake of an honest debate we're not having, and practically speaking, never will.