Arnold Kling wonders: Imagine that Mitt Romney were about to sign legislation that said that from now on, all citizens of Massachusetts may leap from the edge of a cliff, flap their arms real hard, and fly. All I can say is, “Try it and see what happens.”
He goes on to raise his specific objections to the new Massachusetts Health Plan:
1. Because it is a political compromise it is not a clean experiment. It is certainly not a market-oriented healthcare reform, but neither is it pure single-payer. I would like to see them try single-payer, since they are hot to do so. Instead, their experiment has been disowned by single-payer advocates, who will blame its failure on the fact that the private sector was left standing.
2. It completely denies that there is any need to re-consider the cost-effectiveness of health care procedures in order to address the issue of affordability of healthcare. All of the painstaking research I did for my book suggests that if there is anything to be done to significantly slow the growth in health care spending, it has to involve cutting back on discretionary spending, particularly on specialists and high-tech diagnostic procedures.
3. A market-oriented health care system would have health insurance policies with high deductibles. For the most part, this plan goes in the opposite direction.
4. It projects a myth that policy wonks can, with sheer cleverness, come up with a way to make health care affordable for everyone. It overstates the benefits of wonkish solutions like electronic medical records. Again, I take great pains in my book to point out that we will have to make difficult decisions to address health care, rather than use wonkish tricks.
Suppose that five years from now, everyone in Massachusetts has health insurance and the cost of the state subsidy is minimal. In that case, I am wrong about the program, and I will gladly admit it. Meanwhile, since none of the critical details have been implemented, I am in the awkward position of telling people who really want to fly that I think they will wind up smashed at the bottom of the cliff.
Read the whole thing here.