John H. Cochrane wrote a piece that was published in the
Wall Street Journal on December 26, 2013. It has the title: “What to do When
ObamaCare Unravels” and the subtitle: “Health insurance should be individual,
portable across jobs, states and providers, and lifelong and renewable.”
This is a remarkable piece in that it says two things about
the author – maybe even three things. First, it says he is now convinced the
single-payer system is the best way to go with healthcare. Second, it says he
wrote this piece not to make the points he seems to be arguing, but only to
pretend making them while exposing their absurdities. Thus, his possible third
point would be that he wrote a parable which he hopes will reveal itself in the
fullness of time.
To do this, Cochrane must have realized something he was not
seeing before. He must have realized that life is the most precious thing we,
human beings have, simply because we cannot get it back when we lose it. Yet,
we also know that life is the most fragile thing we possess because it requires
much care to maintain. And this is in contrast with say, a robot that can
function without air to breathe, water to hydrate it or food to sustain it. If
it runs out of energy, it shuts down but does not die. And when its batteries
are recharged or replaced, the robot functions normally again.
As to us humans, when we are afflicted with a serious
disease, or even a simple thing like an infection, we want it cured right away
because we know it can spread or metastasize, and turn deadly. Thus, to obtain
the cure and preserve the self or a loved one, we are willing to give the world
away if that's what it will take. And this says that in the final analysis,
healthcare is not a commodity we treat like any other. We may postpone buying a
car, an education or a vacation if the price is not right, but we do not
postpone treating a blow to the head; treating a heart attack or treating a
cancer.
The healthcare providers too know all that. But because many
are dedicated workers, they will not take advantage of the situation to enrich
themselves. Other workers, however, are not as dedicated, and they will do
anything to enrich themselves … as long as they do not cross the line.
Unfortunately, there are those who will cross the line to appease their hunger
for getting rich quickly. They will betray their oath knowing full well what
risk they are taking. Some do get caught, pay a heavy monetary price, ruin
their reputation and give the profession a bad name.
There is also the fact that the health delivery
organizations and the health insurance companies do not have many scruples.
They will charge what the market will bear, and because healthcare is not a
commodity like any other, the most unscrupulous among the people in charge of
those institutions will see an opening where they will do as much as they can
get away with – what Cochrane considers unacceptable. But rather than place the
blame where it belongs, he says this: “The U.S. health-care market is dysfunctional.
Obscure prices and $500 Band-Aids are legendary. The reason is that health care
and health insurance are protected from competition.” This is so laughable; it
is like the father who says: My son is a good boy. It is just that when he does
not get beat up, he tends to go on a rampage and hurt the neighbors.
John Cochrane must be convinced by now of what the advanced
industrial nations have discovered long ago, mainly that a free, open and
competitive market does not work for healthcare. Look what he says: “No other
country has a free health market. The rest of the world is closer to single
payer, and spends less.” Now look in what absurd and deliberate fashion he
argues against that: “Sure. We can have a single airline too … a single-payer
post office … government-run telephones and TV.” He also goes on to say this:
“Thirty years ago every other country had all of these.” He does not come out
and say it, but he knows that the reader knows the world does not have
governments running these industries anymore because those governments
discovered that the free market does a better job running them.
As to healthcare, the world has kept the single-payer system
because the governments have discovered that this system works better for
healthcare. So how does Chochrane argue against that? He says this: “That the
rest of the world spends less just shows how dysfunctional our current system
is, not how a free market would work.” This only adds to the absurdity of his
argument which reinforces the view that the free market is good for many
industries but that the single-payer system is better for healthcare.
And so, having argued his own points to absurdity not to
admit he now believes ObamaCare is the way to go, what does he want to see
happen? Does he want to go from the current system which he says is
dysfunctional, to a brief experiment with ObamaCare which he used to say will
collapse, to a system that was never tested? What else does he want? Does he
want to reject a system that he admits is used by everyone in the world; one
that was shown to deliver at a lower cost? Is that what Cochrane wants?
No, it could not be he wants a system that was never tested,
having seen the country go through so many traumas already. It must be that he
has something else in mind. After all, healthcare in America is worth 16 percent of the
economy. If it collapses, it will bring about a depression, and no one sane
wants to see that happen. So then what does he want to see?
Well, first of all, he says this: “The Affordable Care Act
was enacted in response to genuine problems.” He later says this: “Health
insurance should be individual, portable across jobs, states and providers;
lifelong and guaranteed-renewable.” But what is that if not a definition of
ObamaCare? Later, responding to someone who said: “This is why we need ObamaCare”
he wrote: “No, this is why we need individual, portable, guaranteed-renewable,
inexpensive, catastrophic-coverage insurance.” This is like someone saying “we
need twelve” and Cochrane responding: “No, we need a dozen.”