policy poo

Measuring the health of a society based on the gap between the richest and poorest is fundamentally wrong. It is just a convenient way for looters to create resentment, because a gap tells you nothing about whether anyone's life got better. Run the test. If everyone's real income doubles but the top doubles faster, the gap widens and every person on earth is better off. If the richest lose half their money and nobody else gains a dollar, the gap narrows and not one poor family is helped. A measure that calls the first a failure and the second a success is tracking envy, not wellbeing. Then look at who we are calling poor. A household below the poverty line in America typically has electricity, running hot water, central heat, a refrigerator, a stove, a microwave, air conditioning, a television, a smartphone and a car. That phone carries the accumulated knowledge of the human race and a map of the planet. A hundred years ago no king had any of it. In 1960 most middle-class families had about half. That is what a century of production bought, and none of it came from closing a gap. It came from men building things and selling them cheaper than the year before. The gap gets cited because it never closes and never runs out. A permanent grievance with a permanent remedy attached, which is taking more.

Let me tell you what Obama started. Nothing. The government takeover of medicine starts in 1965 with Medicare and Medicaid. Washington adds the DRG price-fixing system in 1983, where bureaucrats set what a hospital stay is worth. Then come the HMO mandates, certificate of need laws, the FDA's decade-long approval gauntlet, and fifty state insurance codes dictating what every policy must cover. By the time Obama signs the ACA, the government already pays about half of every health dollar in the country. He finished nothing and started nothing. He added one more floor to a structure that has been going up for sixty years. Now look at what it costs. In 1960, before the takeover, health care runs about 5 percent of GDP and most people pay their doctor directly, out of pocket, at prices they can afford on ordinary wages. Today it is roughly 18 percent of GDP, federal health programs run $1.8 trillion a year, the largest item in the budget, and you call the result a market failure. Under the capitalist stretch of American medicine, penicillin goes from a miracle reserved for soldiers to pennies a dose in a few years. The polio vaccine reaches every schoolchild in the country. Prices fall because producers compete for customers who pay their own bills. That is what made cures available to everyone. Your plan is one buyer, fixed prices, and a pipeline that answers to a budget office instead of a patient. Price controls do not make medicine cheap. They make it scarce. The cures that would have reached everyone will reach no one, including the men on that stage, because a drug that is not invented saves nobody, and no one can tax his way to a pill that does not exist.