One goal of health-care reform is to begin to address these market imperfections. But there’s no particular evidence that a government-run insurance plan will be any more successful than what we currently get from big private insurers — unless, of course, the government-run plan is so big or so powerful that it can dictate prices to providers, as Medicare now does. Proposing that, however, would immediately unite doctors, hospitals and drug companies in opposing reform.
You also hear the argument that government-run insurance would have lower costs because it wouldn’t have to generate a profit (that’s true) and would be more efficient than private insurers (that isn’t). The evidence of greater efficiency is Medicare, which spends about 2 to 3 percent of its budget on administration. But if a government-run plan had to spend its own money to collect premiums, market itself to customers, maintain a reserve, and manage care in a way that lowers costs and raises quality — none of which Medicare now does — then you can be sure its administrative costs would be nowhere near 2 or 3 percent.
Pearlstein, who will discuss this article at 11 a.m. on The Washington Post web site, makes some cogent arguments. But what strikes me most about this article is that I must read an opinion piece to get good information on the debate. Shouldn’t Post reporters be detailing the pros and cons of healthcare reform? Instead of spending time covering town hall shoutfests, shouldn’t reporters look into the debate and collect expert opinion on how reform might work, what consequences and trade-offs are, and what other countries have done to address the issues we face?