Spaghetti Bolognese

After a two-day hiatus, we return to Woody Brock and American Gridlock. It is a fitting time to look at his discussion of the second great issue whose resolution has been lost in the politics of nastiness: entitlements, and in particular, health care, which is currently under discussion before the Anointed Nine. The issue of health care is enormously complicated –Brock calls it the “Spaghetti Bolognese of public policy problems – and his chapter addressing it is one of the book’s best. He is critical of “Obamacare,” but for reasons that have received little public notice – unless we address the supply side of healthcare, particularly by creating conditions that will produce more practitioners, America will end up both broke and rationing services. The logic that takes him there involves a fascinating discussion about the much-misunderstood law of supply and demand, but the essence of his argument is that the need to (1) provide access for 50 million currently uninsured Americans and to (2) control costs as a percentage of GDP are on a collision course unless the supply curve expands faster than the demand curve.

Universal health care is a public good, one in which the government must be involved, and so the focus on the “individual mandate,” which has become the centerpiece of the debate, seems nonsensical to me. We already have universal coverage, unless we are prepared to let the uninsured lie in the streets untended. This debate ought to be about making sure that does not happen.