I’ve never read much of Ezra Klein’s stuff in the past, even though it’s been highly praised elsewhere. But there’s no question that yesterday’s opinion piece and today’s online chat are by far the most knowledgeable discussions of health care I’ve ever read in an American newspaper. Read the whole thing, but here’s a sample:
Ezra Klein: No. We don’t have the best health care in the world. Not on any broad measure or metric. We don’t have the most cost effective health care in the world. We don’t have the best outcomes in the world. We can’t even manage to give everyone access to health care.
That said, there are certain diseases, like breast cancer, that we are uniquely good at treating. But then we lag on diseases like diabetes. It’s a mixed bag. And it’s a mixed bag that we are spending twice as much as most other countries on. So it’s important to say this clearly: We have a very, even uniquely, bad health-care system. Not for every individual. But in the aggregate. As a country, we spend far too much and get much too little.
[….]Charlottesville, Va.: Peggy Noonan had a column over the weekend listing three points that damage support of health-care reform. The first one seemed a bit odd — that doctors sometimes undercharge patients who are strapped financially. Is there any evidence out there supporting or debunking this? Any comments on the article overall?
Common Sense May Sink ObamaCare (Wall Street Journal, July 25)
Ezra Klein: Didn’t see her article, but it’s actually the opposite: Doctors overcharge patients who are strapped financially.
This is actually sort of intuitive. A piece of fruit at a good grocery store is pretty cheap. A piece of fruit at a corner bodega is often not. That’s because Safeway negotiate large discounts on behalf of their customers while the bodega doesn’t. Similarly, people with insurance — be it Medicare or a large employer’s plan — have negotiated discounts. But people with bad insurance, or no insurance, don’t. And so they end up paying a lot more.
I’ve taken a lot of shit here for supposedly overestimating the effect the punditocracy has on our government. But I sincerely believe that if Klein had had an public opinion page gig for the past 17 years and David Broder hadn’t, this country would be in a different place. Even though that means Klein would have started when he was eight.