Oppose medicare

Reader comment on: Lipsky on a Press Subsidy

Submitted by benjamin Geballe (United States), Oct 22, 2009 20:19

I am not so sure that lumping medicare and the public option (whatever that may turn out to be) in with the industries who recieve subsidies makes much sense. Medicare is available to every person in the country over 65. It is not targeted at a specific group. Would the author advocate abolishing medicare? If so, why not end public schooling as well? Fire Departments?

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The Future of Capitalism replies:

The doctors make a lot more than the teachers or the firefighters (just check out all those Mercedes, Lexuses, and BMWs with MD plates over in the physicians' parking lot at Methodist, which serves a large population of Medicare and Medicaid patients). If the government imposed a payroll tax on every American and used the proceeds to buy everyone over 65 a newspaper subscription, the reporters and publishers might be driving fancier cars, too, and one hopes that they'd at least be open about acknowledging they are getting a subsidy. But I wouldn't get too hung up on the word subsidy. Whether you conceive of it as a subsidy for doctors or not, even President Obama acknowledges (or claims) that there's hundreds of billions of dollars of waste and abuse in Medicare, and that the current growth trends in the program's expenses are unsustainable. Public schooling is another kettle of fish, but I agree there are parallels to health care -- there, in some cases, the unionized teachers are doing almost as well as the doctors ($100,000 a year in New York City for a job that comes with Summers off and regular weeklong vacations on top of that) -- while student outcomes don't compare particularly well internationally. At least the medical malpractice system, for all its many faults, punishes bad doctors, while bad teachers just end up in a "rubber room" (see Steve Brill in the New Yorker). And at least most patients, even in Medicare, have a choice of doctors, while many students don't have much of a choice in schools, unless they pay extra for private or parochial schools while their tax dollars are still taken from them to pay for the schools they do not use. The broader point is that just because a subsidy has both an end user (patient, newspaper reader, student, baseball fan, wind energy user) and an agent (doctor, newspaper owner, teacher, baseball team owner, investor in alternative energy company) is not a reason to focus solely on the end user at the expense of the agent. (Nor, for that matter, and in all fairness, to focus solely on the agent at the expense of the end user.) The point isn't that no teachers or doctors or baseball team owners should drive fancy cars, either. But as a general rule, things work best when individuals make these choices of which industries to spend their money on, rather than the government deciding it is going to favor investment in one industry or firm over another, because when the government makes the decisions, the powerful (well-connected) (unionized teachers, doctors, baseball or basketball team owners, unionized auto workers) end up benefiting at the expense of the powerless (public school students, patients, non-unionized nurses and home-health-care aides, property owners who have their homes seized by eminent domain to construct new stadiums, taxpayers who aren't unionized auto workers).

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