Reading over this conversation, and looking over some of the other interesting things being said about health care policy around the Web, I find myself wanting to approach health care policy by starting with a blank piece of paper and seeing what I come up with.
Clark, I can pretty much guarantee that I won’t come up with “managed competition.” To me, managed competition means combining public sector rigidity with private sector greed, leading to things like the California energy debacle of a few years ago.
Jonathan, I also doubt that I will come up with a universal system as a solution, instead of a system where the government takes care of the very poor and the very sick. Your argument against the latter is that government will offer inferior care to the poor and the sick, but with a universal public system we will offer the same care to everyone. I think that a universally good public system is a dream. My guess is that such a system would turn out more like the public school system, with the most affluent and health-conscious staying away in droves. To use terms with which I hope you are familiar, “exit” is a much better tool than “voice.”
As for tenure at an Ivy League University representing a certificate of intellectual honesty — Jonathan, don’t get me started. It is my contention that we in the elites are skilled in the art of intellectual deception, including intellectual self-deception. Resisting deceiving others and fighting the tendency to deceive oneself are ideals that are much higher than those typically found in the ivory tower. I am not being insincere when I say that I impressed by your willingness to give credit to alternative points of view. I hope that I do the same.