In this talk, Greg Mankiw says a number of wise things. For instance, he says that in health care, the main issue is whether spending restraint is going to be conducted top-down from government or bottom-up from individual choice.

But then he says that a compromise solution would be some sort of regulated competition among health plans. I do not see how that could turn into anything other than top-down. It is where Massachusetts is headed, for example.

Other possible compromises:

1. Federalism. Let different states choose different paths. Vermont wants to be single-payer. Maybe some other state wants to be market-oriented.

2. Two-tier health care system. A top-down, government-run system, perhaps modeled on the VA (remember a few years ago when that was being touted as a model system?), that is available to everyone, along side a market-oriented system that is available to those who want and can afford it. In fact, you could give poor people vouchers, so that everyone can choose between the market-oriented system and the VA model.