I think Josh Marshall nailed the worst part of Jeb Bush’s week so far: not one of the GOP’s usual hacks jumped to defend him over Iraq, and in fact he seems to have kicked off a Republican stampede away from Iraq and his now twice retracted position on it. That pretty much guaranteed that Jeb would have to clarify, face humiliating questions about it and then double back and ultimately toss his brother’s war back under the bus where he found it.
His Friday is not looking much better. In a nut, the most generous way to interpret what he just said to some supporters in Arizona is that tech innovation and the free market makes great things like the Apple watch, so it ougt to make great health insurance as well.
The health beat is usually Richard’s bailiwick, but I think I can handle this. If we imagine that Bush meant something completely different from what he actually said, that tech and the market can provide great care, then he’d be on the right track. Hospitals are full of all kinds of nifty gadgets. On the other hand I can think of plenty of reasons why that counterfactual argument is just as stupid. Innovation to make people healthier is also known as biomedical research science. I do that all day and have done for a while in a variety of settings, and I can say that without constant government investment new advances would dry up in a hurry. Even private research firms like Pfizer would grind down to a near-halt since, little known fact, a lot of what they do is license intellectual developments made in government-funded research and get them ready for market.
Even when it comes to fancy new scanners and such the invisible hand needs help. A lot of fancy tech fails to deliver on its marketing promises and some technologies actually make things worse. Without independent, publicly-funded research to test the usefulness of a new device most products of the free market will make health care more exclusive, a lot more expensive but no better at making anyone less sick. Come to think of it health care technology that is unnecessarily expensive, exclusive, buggy and not very useful for its intended purpose is a great analogy for the Apple watch.
But there really is not any ambiguity about innovation in health insurance. Without government oversight more or less every single innovation in the insurance marketplace will be solely dedicated to separating patients and hospitals from their money. In the pre-PPACA dark ages major insurers kept massive divisions of denial experts in a constant state of fevered competition to find the greatest loopholes, small print and outright fraud to keep customers from collecting on their claims, and that only counts the lucky customers whose clean health record earned them entry in the first place. For people lime me who truly understand the capabilities of genetic sequencing, the value of cheap genomics for insurance denial was, frankly, scary as hell. To people on the receiving end that invisible hand would look and feel a lot more like a, well, you get the idea.