Critical Condition

NRO’s health-care blog.

Mickey Kaus and Realism


Mickey Kaus does not understand why the choice between health-care rationing and other forms of cost containment “has to be Euro-style rationing . . . if we’re willing to make the alternative hard choice of raising taxes (or cutting other spending) to pay for avoiding it.”

Kaus — normally a sensible guy — seems not to understand that needs, whether medical or other, are infinite, while resources remain limited, always and everywhere. Even in principle, therefore, “universal coverage” must evolve, quickly, into something far less compassionate; and in any event, tax increases, even on the middle class, cannot be sufficient to avoid rationing, precisely because the new/expanded programs funded by them will increase demands on the system. And at some point higher taxes will not yield higher revenues, although that seems to be a virtue in the Fairness World of President Obama.

What other spending will be cut to finance ever-greater health-care demands in a bureaucratized system? Kaus does not tell us. What he must know instinctively, however, is that government has interest groups rather than patients, so the availability of other spending cuts to pay for federalized health care is rather limited. Has Kaus not noticed the political effects of the proposed cuts in Medicare?

Benjamin Zycher is a senior fellow at the Pacific Research Institute.


Sign up for free NRO e-mails today:

Subscribe to National Review