Heads Up

Catastrophic Care: How American Health Care Killed My Father — And How We Can Fix It by David Goldhill has a good chance to be the Losing Ground of the health care debate. Since he identifies as a Democrat, I don’t think Goldhill would like the comparison, but Murray’s book was a lot less conventionally conservative or libertarian than a lot of people remember. Losing Ground specifically praised the structure of the New Deal social insurance programs even as it dismissed a generation’s worth of conservative criticisms of AFDC.

What Losing Ground did was provide an analytical framework and urgent moral arguments for reforming welfare for the sake of welfare recipients. Goldhill does the same thing by arguing that moving to a combination of catastrophic insurance, price transparency and provider competition, we can increase the take home pay of workers and increase the quality of care for patients (and these are the same people at different moments.) Like with Charles Murray and welfare, I don’t expect that Goldhill’s particular proposals (including a program of mandatory universal catastrophic health insurance and mandatory Health Savings Accounts) are going to be enacted by Congress. What Goldhill does is provide arguments against the combination of comprehensive health care prepayment and centralized denial of care that is the endpoint of Obamacare. That opens up room for the more modest reforms proposed by James Capretta and Thomas Miller plus supply side reforms to make it easier for new providers to enter the health care market.

In a year’s time, every Republican member of Congress and every Republican congressional candidate should be given a quiz on the ideas in Catastrophic Care ( though you can run across similar ideas in places like the National Interest.)  If some Republican member of Congress or congressional candidate is ignorant of those ideas, then you will know they are a fraud when they tell you how serious they are about repealing Obamacare.