Okay, not everybody is happy this morning. For my less-enthused readers, I thought I’d post a special edition in our “What to Read” series. Herewith, I reproduce the best articles, columns, essays, and posts that I’ve read on the health care debate since I started this blog. But first, I want to second Steve Coll’s motion to celebrate one journalist in particular:
If you, like me, are uplifted by the historical potential of Sunday’s vote, then the best way to sit still inside what has happened is to scroll back through Ezra Klein’s blog. If you haven’t been reading Klein throughout the health care reform debate, you’ve missed one of the inspiring examples of how new forms of journalism in the hands of a new generation of journalists (who don’t always admire, but don’t always disrespect, the example of the generation before them) can produce vital new work. Klein is an example of a policy wonk in possession of both passionate opinion and scientific method who put himself into position to cover the dull-but-important story of a lifetime.
Coll has inspired me to create a new tradition for this blog: a “Journalist of the Year” award. With a little backdating, we are proud to honor Ezra Klein with the 2009 Trading 8s “Journalist of the Year” Award.
American Health Care — Richard Posner – Becker’s original post, to which Posner replied, is worth a read, but Becker ignores the larger question that David Leonhardt pointed out about prostate cancer a few weeks ago: We can probably achieve just as good results with far less expensive treatments. Posner is right that it’s all about cost-benefit analysis. As indicated by Brownlee in a quote I used in my post on the issue, prostate cancer is one of the areas where we excel, yet we don’t do much better than the United Kingdom. Becker doesn’t mention a lot of other areas where we fall short, including infant mortality, medical errors, customer satisfaction, and yes, even waiting lines (ours are longer than France’s and the Netherlands’). And much of the reason that we make all the behavioral mistakes that Becker says (where he conveniently assigns the blame to us instead of the system) is because our doctors have a financial incentive to give us expensive treatments instead of inexpensive preventative advice. The beauty of “evidence-based medicine” is, if the procedures we use really are so effective at treating a particular disease, then the evidence will reflect that and doctors will be encouraged to use those procedures. The goal, remember, is to reduce unnecessary care, not treatments with a proven track record.
Health Care Premiums Run Amok — David Cutler – When reading estimates about how different proposals will affect you, be careful that they are not using the current premiums, or even inflation-adjusted premiums, as their baseline for the next decade. What matters is how the reform compares to what will happen if we do nothing, which is summarized neatly here by one of America’s best health economists.
Kyrgyzstan: At the Crossroad of Empires, a Mouse Struts — New York Times – The key quote, “neither has publicly condemned the heavy-handed tactics of the Kyrgyz president, Kurmanbek Bakiyev, who easily won another term last week in an election that his opponents said was rigged,” was thrown in as an afterthought. We get all bent out of shape over Iran and Honduras, but don’t anyone dare say a word about Kyrgyzstan! We’ll let them get away with whatever they want, so long as we can use them for our military bases. And how do the citizens of the Middle East feel about that? I seem to recall a similar situation with Saudi Arabia leading to the emergence of a little group called Al Qaeda… And then we complain when reformers have trouble bringing democratic reform to these nations!
The Bernanke Reappointment Tour — Calculated Risk – All good points, especially the last sentence. A lot of it depends on whom the President would replace him with. If it’s Larry Summers, then we had better root for Ben Bernanke. If it’s Janet Yellen, we might want to reconsider. Roubini is right, though, that Bernanke prevented the recession from becoming a depression, and that is no small feat.
CBO Kills the President’s Medicare Commission Proposal — Keith Hennessey – Hennessey is missing the point. He is right to quote CBO language that criticizes IMAC, but the CBO is not saying IMAC is a bad idea. They are saying it should be even stronger and more powerful, which, if you understand the history and economics of health care, makes perfect sense. (I should also note, for example, that if IMAC only has power over Medicare and not private insurers, then we can expect hospitals to shift resources to milk private insurers as they did after the last major Medicare reimbursement change under Ronald Reagan.)
Update:The New York Times has now expanded its article on North Korea. It seems the first draft was just a placeholder until they had time to write a full article. I take back my criticism and reiterate my plea to President Obama to seize this opportunity.