David Brooks on Health Care

David Brooks has a column in the New York Times this morning about health care. Besides making it clear where he stands on taxes ("the Democrats have admirably agreed to raise taxes," he writes) the article says that if the proposed health care overhaul passes Congress, "more of the nation's wealth would be siphoned off from productive uses and shifted into a still wasteful health care system." This strikes me as a false dichotomy. If a drug company or a doctor finds a cure or a treatment for cancer or some other debilitating or deadly disease, isn't that "productive"? Wasn't the invention of magnetic resonance imaging productive? If you can extend someone's life, that gives that person more years to be productive. Medical advances such as in vitro fertilization make it possible for couples who might have been infertile to create children who will grow up to be productive entrepreneurs or taxpayers. The idea that just because something is health care means that it is therefore "unproductive" just doesn't make sense. Sure, there's waste in the health care system. But there's waste in lots of other sectors of the economy, too. Some nurses who are busy changing bandages on AIDS patients this morning may think that it's wasteful to spend money on diamonds or fur coats or Rolls-Royce automobiles or meals at restaurants fancy enough to rate a review in the Times food section. Is what the nurse is doing more wasteful than what the diamond merchant or furrier or Rolls-Royce dealer is doing? Never mind the fact that some of the "waste" in the American health care system may be a result of the fact that the government already controls 45% of health care spending. The obsession with rooting out "waste" is something that Amity Shlaes spoke of the other night in her Hayek Lecture as a characteristic of New Deal-era arrogance and central planning. The communists used to complain it was wasteful to have all those different brands of breakfast cereal in America when all anyone really needed was one. Think of all the supermarket shelf space and advertising dollars that could be saved! No one is in favor of wasting the government's money. But in capitalism, what can sometimes look like waste is actually competition, or prosperity, or free choice. (Update: Even the usually dependable Greg Mankiw thinks Mr. Brooks "gets it right.")