Hedge Funder Cliff Asness Returns To Teach You About Health Care

A guy writes a piece claiming that the politicians supporting the Administration's healthcare proposal know it will make healthcare worse, but lie about that in order to increase their power.

You reply, "How about a little presumption of your opponents' good faith?" and pat yourself on the back for refuting him, with the modest qualification that "we've heard a lot of these arguments before, and they're pretty easy to refute."

Do you consider it logically impossible that a politician would lie, or act to increase her power rather than for the public good? If not, then you need some evidence or argument in this particular case to count as a refutation.

Your 969 words (since you're counting) offer counterpoint to some of the points in the original essay. Taken together, they amount to a case that the current healthcare system is bad, that less government won't fix it and that more government might. Neither you nor Asness has cited much in the way of evidence, nor even refined your terms enough to come up with direct contradictions. But that's okay, they're competing op-eds, not policy papers. However you never get to Asness' claim that the Administration plan is terrible and the people pushing it are cynical liars. Whether there could be a good government plan, or a good free-market plan, is not the issue.

For the record, I favor removing the government tax and regulatory pressure for employer-based health plans, for providing inexpensive care for everyone (say on the level of UK national health or the Veteran's Administration) and letting everyone who wants to spend more contract freely with people who want to make profits delivering it. I agree we spend far too much, but think the Administration plan will spend even more and deliver less. I'm particularly upset by provisions preventing people from making private insurance or care arrangements, even after they've paid taxes to fund the public system, and preventing businesses from attempting to make profits. I agree with Asness to the extent that some portions of the plan smack of punishing the middle class (rich enough to afford more than UK/VA-level care, but too poor to pay for it without insurance cost-sharing and too poor to fly overseas for treatment) and criminalizing profit, without any conceivable public policy purpose beyond radical egalitarianism.

Therefore, I'm far more concerned about the motivations of the people pushing this plan than the financial and medical details. If they're honest people with good intentions, maybe some of the offensive provisions are oversights that can be corrected after implementation. If they're heartless petty dictators, I want to stop it right now. What we have isn't bad enough to give in to that.

So to my mind, you haven't begun to refute Asness. He may well be wrong, but I'd like to see some analyses before I suspend my disbelief and trust the government.

if you think your state is less disgusting than others on medical lawsuits (and let's not even talk about science and Texas courts).

All four guys, Tex (maybe a gal), Nick, Baker and Asness are throwing around facts, and dismissing counterfacts ("some of the [drug company revenue] goes to bribing doctors" instead of funding reserarch, "only one state" isn't enough to make a difference). Despite widely differing polticial stances, most of the issue can be resolved by empirical investigation, which requires careful analysis of millions of facts, not random quoting of unsupported facts.

I think pretty much everyone who looks at this seriously agrees that the UK and Canada, and US government programs like Medicaid and Veteran's care, deliver too low a level of care to be acceptable for everyone. I think it's enough to satisfy the minimum state obligation to the poorest people, but I can't abide the idea of preventing everyone from getting anything better.

I also think we can rule out inference from tiny Northern European countries without the scale and situation to be comparable to the US.

The useful issue to resolve is whether France and Germany get better healthcare for their money than the US, adjusting for demographic differences and share of medical innovation funded. Nick and Baker cite this as if it is indisputable fact, Asness (and Tex seems to agree) appear to know that France and Germany are barely a half notch above old Soviet Union care.

This doesn't seem something that should be a matter of pure opinion. If France and Germany really have it so much better then anyone but a radical libertarian ought to be disposed to imitate some of their practices, maybe even invite a few of their administrators over here to help. If France and Germany are really free-riding parasites who spend almost as much as the US to get care that only looks good because they don't cover their old or sick immigrants and have a homogeneous population with low expectations outside of an inbred elite then only a card-carrying socialist would want to move in that direction.

So why toss random factoids around or engage in ideological chatter that only matters to the 1% extremes? That's what I'm afraid is happening in Washington. You four may hope that will provide the cover for your favored parties to win, but face it, all the favored parties will win; and none of us are favored. The more heat and less light there is on this issue, the more likely we are to end up with the worst of socialism and unfettered capitalism.