Dan Weintraub has a stupid column about single-payer health care that uses the same rhetoric that has locked us into a broken status quo for the history of the Republic.  He claims that a new legislative analyst’s report of the costs of SB840, if implemented today, would leave the state $40 billion dollars in the red after just one year.  That’s true, but as Sheila Kuehl explains, that’s because health care costs have soared while wages remain stagnant, and thus the numbers from the original assessment of the bill are completely out of date.  Weintraub then achnowledges this, but asserts that only 50 percent of the deficit can be attributed to a run-up in health care costs.

Of course, that’s $20 billion dollars.  And one element that Weintraub refuses to consider is cost control, which is the only way any fundamentally new health care system will survive, be it single payer or a collective-responsibility plan like that rejected by the State Senate last year.  Weintraub never tries to factor in cost control.  He never manages to analyze whether or not a system that takes middle men out of the process and removes the profit driver might be able to reduce the price of quality care.  In the same way he never considers whether mandating that insurance companies spend a high percentage of premium revenue on treatment and care would reduce those costs he sees as fixed.

Spending on health care is out of control because there is a patchwork quilt of delivery services, diced up between insurers, hospitals, managed-care organizations, and other elements who add cost without impacting quality.  It’s, in short, an efficiency problem; the United States is grossly inefficient in its delivery of services, and despite superior technology and high spending has a life expectancy which trails 30 other countries and has the highest rate of underweight babies in 40 years, to cite just two examples.  Subjecting a fiscal analysis of a system that would eliminate or sharply reduce the fiscal burden of this quilt to the old rules, and the old costs, makes no sense whatsoever.  It’s like doing an fiscal analysis in the 21st century of the naval budget, factoring in the effects of ships falling off edge of the world.

There’s also the moral argument that we have over seventy million uninsured and underinsured Americans in a country which lists “life” as a fundamental inalienable right.  But I’ll shove that aside for a moment to deride Weintraub’s limiting analysis.