Liberal bloggers are taking Greg Mankiw to task for his piece in the New York Times this weekend analysing some popular--and, according to Greg, partly fallacious--statements about US health-care. Greg argues that superior life-expectancy figures for Canada and other countries are misleading; that the numbers for the US uninsured are in some ways exaggerated; and that the anomalously high cost of US health care may be, in part, a sign of success.
I agree with Greg much more often than I disagree, and his site is one of only three or four where I am careful to read every post, but we part company on this subject. What he says about those three statements is correct, of course, as far as it goes--but as an overall assessment offers little reassurance that all is well, so far as I am concerned.
Even if American health-care is better than Europe's most successful systems--which is debatable at best--one surely cannot argue that at current outlays it delivers equal value for money. And on the numbers of uninsured, I agree with Dean Baker that one might just as easily argue that the usually cited figure of 47m is understated. First, because it does not capture all those who are uninsured at some point during the year. More important, because it says nothing about the justified anxiety suffered by Americans who worry about losing their coverage in future, when they most need it. I think this last point is crucial to the politics of the whole debate. It is an anxiety that tenured academics doubtless feel less acutely than most others.
Any reform should carefully focus on this group [the uninsured] to avoid disrupting the vast majority for whom the system is working. We do not nationalize an industry simply because a small percentage of the work force is unemployed.
If a good part of that vast majority is troubled by the fear that their coverage may evaporate, the system is not working for them as well as it could. And who any longer proposes nationalising the system? Not the Democratic presidential candidates. They want to do for the country what Mitt Romney did for Massachusetts: universal coverage based on the existing mostly-private model. Does Greg (one of Romney's advisers) regret that reform?
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