David Goldhill makes a lot of the points that I have been making. Two excerpts:

But fundamentally, the “comprehensive” reform being contemplated merely cements in place the current system–insurance-based, employment-centered, administratively complex. It addresses the underlying causes of our health-care crisis only obliquely, if at all; indeed, by extending the current system to more people, it will likely increase the ultimate cost of true reform.


for every two doctors in the U.S., there is now one health-insurance employee–more than 470,000 in total. In 2006, it cost almost $500 per person just to administer health insurance. Much of this enormous cost would simply disappear if we paid routine and predictable health-care expenditures the way we pay for everything else–by ourselves.

I could have chosen much more to excerpt. Read the whole thing.

The question is: why are views such as Goldhill’s, or John Mackey’s, or mine, so beyond the pale? Possibilities:

1. Health care is something that people deeply feel ought to be paid for by someone else. No one even wants to pay for their own insurance, much less pay providers for treatment. The political process is trying to give people what they want.

2. Progressive ideology is that technocrats know best. Swarms of progressive intellectuals mobilize to kill any idea that conflicts with their ideology.

3. What seems clear and logical to me is in fact wrong. Contrary to my thinking, we really could have an affordable health care system managed in Washington. We could have an affordable system by getting rid of profits or by government rewarding quality or by government funding of prevention or some other progressive magic bullet.