Virginia Postrel says do Medicare first:
Think about this for a moment. Medicare is a huge, single-payer, government-run program. It ought to provide the perfect environment for experimentation. If more-efficient government management can slash health-care costs by addressing all these problems, why not start with Medicare? Let’s see what “better management” looks like applied to Medicare before we roll it out to the rest of the country.
This is not a completely cynical suggestion. Medicare is, for instance, a logical place to start to design better electronic records systems and the incentives to use them. But you do have to wonder why a report that claims that Medicare is wasting 30 percent of its spending thinks it’s making a case for making the rest of the health care system more like Medicare.
Because they think we’re rubes. And judging by the voting results last fall, many of us are.
This reminds me of the old Soviet joke (that I’m sure I’ve related at this blog, perhaps more than once, but it remains appropriate). A teacher is lecturing schoolchildren on the brilliance of Karl Marx. A kid raises his hand, and says, “Teacher, was Marx truly a great scientist?” She beams and nods, and declares him the greatest scientist in the history of mankind. “Well,” he went on, “then why didn’t he try this crap on rats first?”
[Saturday afternoon update]
Peter Orszag has responded to Virginia’s question. Hail the blogosphere.
I find this quite telling:
Medicare First–changing Medicare and waiting to see how it works before messing around with the rest of the health care system–won’t work politically.
You don’t say…
Some people might think that cause to rethink. But not these people.
[Bumped]