12.08.2009

Evolution of a talking point

Atul Gawande in The New Yorker tries to convince us that the costs of health care reform don't matter, by using the example of farming at the turn of the last century:
The history of American agriculture suggests that you can have transformation without a master plan, without knowing all the answers up front. Government has a crucial role to play here—not running the system but guiding it, by looking for the best strategies and practices and finding ways to get them adopted, county by county. Transforming health care everywhere starts with transforming it somewhere. But how?
What he fails to mention, of course, is that one of the most lasting impacts of the government intervention in farming has been subsidies, which have not only cost tremendous amounts of money, but have also served to run up food costs in the long run:
The burden of higher domestic food costs falls disproportionately on poor households. Farm protections act as a regressive tax, with higher prices at the grocery store negating some or all of the income support the government seeks to deliver via programs such as food stamps.
It's funny that we've gone from "but it will bend the cost curve!" to "let's just spend like drunken sailors!"