A progressive position on health care

As our steering committee meeting today spent substantial time on health care, this Ezra Klein (the American Prospect) post might be of interest:

Kevin Drum:

As progressives, our goal shouldn't be to provide gold-plated care to every person in the country, nor should it be to restrict the ability of the rich to get better service if they want to pay for it. Our goal should be to provide decent care to everyone, with the market free to operate on top of that.

How Kevin was able to get an early glance at my next tattoo is anyone' guess (I had the whole thing translated into kanji, too!), but that's a pretty perfect description of how I understand the role of the progressive health reformer. It's also why I joke at panels that my plan for health reform is invading France and taking their system. I'm down with no blood for oil, but I'd give some blood for universal coverage.

Meanwhile, a quick thought on cost control: When talking about costs, folks need to distinguish whether they're talking about getting more value for each dollar or reducing total spending. The two might not be the same. Prevention, for instance, gets far more value out of each dollar. But if it keeps people alive a whole lot longer, that's more time for them to contract various illnesses, and when they grow old, to die from something expensive. So though prevention may mean our health dollars are doing a whole lot more good, it may not mean we're spending less as a total percentage of GDP. Conversely, we could outlaw coverage of statins, which would save some money, but kill a lot of folks. Now, I'm not saying the two ends are opposed. Indeed, getting good value is probably a complementary goal to spending less. But it's not the same thing.