Kevin Drum has a killer big-picture post asking why it's so difficult for liberals to make the argument for health care reform. I want to begin where he ends, with a graph comparing how much countries spend on health care throughout the world. Guess who "wins" by a wide margin?
Well, there's a reason that data is rarely mentioned: it's because the Democratic plans on offer right now do very little to change it. For all the sturm und drang about rationing and killing grandma and so forth, the House and Senate bills currently on the table would have a pretty modest impact on the future growth of healthcare costs.
And there's a reason for that too: the only way to cut costs is to piss off the people who benefit from those high costs: doctors, hospitals, insurance companies, device manufacturers, and big pharma -- all aided and abetted by patients who never, ever want to be told no. It would be nice to think that we could enrage all these groups and still pass a healthcare bill based on sheer populist rebellion, but that's not in the cards. It just isn't.
I find my head nodding quite a bit to those paragraphs. Matt Yglesias moves the ball a little further down the court by wondering whether this graph -- or at least an argument that put this graph into words -- would be a powerful point for Democrats.
The conventional wisdom, as expressed in this Third Way strategy memo, is that talking about foreigners is for losers: "Don't compare the U.S. to other countries, or assert that America does not provide quality health care. (i.e. Do not cite statistics that say the U.S. is 37th in the world in health outcomes)." They don't, however, share with us the research on which this is based...I don't see how failing to mention that results are actually better in other countries actually lets you avoid the argument. It seems to me to just avoid having a chance at winning it.
I'm certainly not opposed to the kitchen sink approach to public relations. There are, after all, hundreds of town halls across the country, and our laboratories of democracy could potentially make good laboratories for incubating health care PR. But contra Yglesias, I think we do have research suggesting Americans don't want to be told their health care quality stinks. Here it is:
More than 90 percent of American voters have health care and more than 80 percent think their quality is good or excellent. That's why I expect (but don't know for certain!) that the first graph above would do nothing to move the chains. When Americans see statistics that are disharmonious with their worldview, it's all too easy to simply tune them out, or blame the messenger for crabbiness.