Tim Fernholz still isn’t disputing any of the factual claims I have made, but he does contest their significance. Take away the sneering, the tangents, and the exclamation points, and what’s left is Fernholz’s view that increased insurance premiums are a short-term price worth paying because universal coverage might turn out to be indispensable to future cost-saving reforms. And anyone who finds this wispy argument unpersuasive is not only wrong but not even worth taking seriously. Thanks to the Democrats in D.C., we might just get a chance to see if this trade-off–higher prices now in return for possible savings at some point in the future–plays as well with the public outside Massachusetts quite as well as Fernholz expects.