BRADLEYCARE
Bill Bradley says that his new health-care subsidies could cost as much as
$65 billion a year. But estimating these things can be perilous. In 1965,
when Medicare was created, it was projected that by 1990 it would cost $12
billion (in 1990 dollars). The actual price tag: $110 billion. Government
spending on health care drives up demand, and makes further subsidies
harder to resist.
Give the Clintons credit for this: Their health-care plan of 1993-94 tried
to address both the problems of insufficient access to health care and
rapidly rising costs. Their solution was to create a regulated oligopoly
of HMOs to ration health care. The public rejected this solution because
it threatened the quality of care. Since then, the administration has
tried to improve children's access to health care, but it has mainly tried
to ensure high-quality care — Clinton learns fast politically — while
raising costs and reducing access. Bradley's proposal shifts the focus
back to increasing access while raising costs.
The ideal, obviously, is low cost, high quality, and wide access, but
evidently policymakers can only get two out of three. Trade-offs will
always be with us; the question is whether we are better off with
individuals' making different trade-offs according to their circumstances
and preferences or with governments' attempting to make those trade-offs
for everyone--with all the bureaucratic inefficiency and politicization
that option implies.
There's a lesson here for those House Republicans, including many
conservatives, who are letting their distrust of HMOs lead them to support
federal regulations that will raise costs and reduce access. Unless they
do more to empower individuals — e.g., through medical savings accounts or
universal tax credits for health care — they will keep walking around in a
circle.
GIULIANI TIME
For months now, the same question has been raised by every move Hillary
Rodham Clinton has made: What could she have been thinking? Now it's
Rudolph Giuliani who's causing head-scratching. He came out yesterday for
freeing convicted spy Jonathan Pollard. This is bad policy: Treason is
treason, and it was not for Jonathan Pollard to determine that passing
along secrets to Israel wouldn't hurt the U.S. It is also bad politics: It
distracts attention from Mrs. Clinton's unpopular stand on government
funding for obscene anti-Catholic art; it undercuts the attack on her as
soft on crime for having supported clemency for Puerto Rican terrorists;
it undercuts the attack on her as a panderer to ethnic groups; it even
detracts a little from Giuliani's otherwise fantastic anti-crime record.
He tries to avoid the charge of pandering by saying he's taken this
position for years, but that just raises the question of why he chose this
moment to speak up — and is just as disingenuous as Mrs. Clinton's
explanations about her position on the Puerto Rican terrorists. Any
increase in Jewish support for the mayor is not likely to compensate for
what this decision will cost Giuliani.
VCIA
The CIA plans to start an in-house venture-capital firm in Silicon Valley.
So that's why they call it "The Company."
