Patterico's Pontifications

7/21/2009

The Unbearable Lightness of Ezra Klein (and Jon Chait)

Filed under: General — Karl @ 9:08 am



[Posted by Karl]

Lefties Ezra Klein and Jonathan Chait cannot contain their contempt for Harvard Economics Prof. Greg Mankiw on the cost of Obamacare. As Klein fulminates:

[T]here’s a weird tendency among people to think that very banal comments are very important insights when they come from Greg Mankiw. And this is worse than a very banal comment: It’s disengaged with the debate.

Mankiw’s basic argument is that health-care reform should be better than deficit-neutral. It should be deficit-improving. That is to say, it should bend the curve in the long term. And it should! But what evidence does Mankiw have that it won’t?

In reality, the average person will wonder why we place the burden of proof on the proponent in science, legal proceedings, and so on — but not when it comes to placing one-sixth of the US economy under government control. Nevertheless, Klein presses on with his list of admittedly speculative cost-cutting hypotheses:

There’s the theory that comparative effectiveness review — particularly when combined with a new IT infrastructure that could eventually help guide physician decisions — will cut down on unnecessary treatments and allow us to bring high-spending regions of the country into sync with their low-spending brethren.

There’s the idea that the Independent Medicare Advisory Council will be the locus for a continual process of Medicare reform that will begin to bring down costs in the Medicare program, and also create a sort of “best practices” laboratory where experiments can be attempted and the best efforts can be further developed.

There’s the argument for the public plan, and in particular the public plan with Medicare powers, that implies that a large purchaser in the center of the system could bargain better discounts with providers.

There’s the argument that the health insurance exchange will grow to become the primary insurance market and that as insurers begin competing on grounds of cost and quality — as opposed to risk selection — that efficiencies will emerge and spending will drift downward, and over time, the employer-based market, which is responsible for many of the costly problems in the system, will begin to migrate toward the exchange.

At Corrente, lambert lambastes these speculations on their (lack of) merit from the Left. It would be just as easy to do so from the Right. However, it is simpler to point out that Klein’s arguments for cost-savings — rationing by unelected bureaucrats, arbitrary price-setting through unfair competition from the government, forcing people to buy government-designed insurance in government-created “markets” — are all reasons why public support for a government takeover of our healthcare system is waning every day (most recently evidenced in the USAToday/Gallup and Politico polls). Jonathan Chait manages to one-up Klein by suggesting that Mankiw’s “understanding of American politics is rather shallow.” In reality, the “banal” observation that healthcare reform is stumbling because people do not want to pay sure costs for speculative benefits is exactly what Ezra Klein wrote earlier this month.

–Karl

28 Responses to “The Unbearable Lightness of Ezra Klein (and Jon Chait)”

  1. There’s the theory that comparative effectiveness review — particularly when combined with a new IT infrastructure that could eventually help guide physician decisions

    Exactly. I’m all for effectiveness review but, as a medical blogger put it the other day, not Effectiveness Review. I’ve previously described here the experience of Oregon which decided to use a sort of effectiveness rank to decide Medicaid coverage for expensive treatment, like liver transplants. When they completed all their analysis and the IT software spit out the list of priorities, the first ranked intervention was treatment of the common cold.

    This, of course, was an absurd result since the cold doesn’t require any treatment by physicians but this is the sort of process that will be constructed, no doubt with a heavy thumb on the scale by the payment masters.

    Once something like this gets going, it will be as difficult to stop as farm subsidies.

    Mike K (90939b)

  2. Mike K,

    Unsurprisingly, the idea of effectiveness review polls well… until you ask whether the gov’t should be doing it, at which point support drops into the 40s.

    Karl (f07e38)

  3. The claims that these immense medical databases are going to cut costs are truly hilarious to those of us with actual experience in the IT industry.

    And of course, the tension created by Federal privacy law, where HIPPA has actually discouraged the creation of medical databases among some providers, is all the more hilarious.

    SPQR (5811e9)

  4. Professor Bainbridge has this oldie but goodie.

    Joe (a32cff)

  5. Uncle Milty is always timely isn’t he?

    Joe (a32cff)

  6. We are seeing a lot of this attempt to shift the burden of persuasion recently. Its virtually a confession of a failure to be able to actually present a coherent argument.

    SPQR (5811e9)

  7. a new IT infrastructure that could eventually help guide physician decisions

    It can’t be bargained with. It can’t be reasoned with. It doesn’t feel pity, or remorse, or fear. And it absolutely will not stop, ever.

    happyfeet (71f55e)

  8. …are all reasons why public support for a government takeover of our healthcare system is waning every day (most recently evidenced in the USAToday/Gallup and Politico polls).

    Which would explain the President calling liberal bloggers to get out the truth. The waning support is not going unnoticed.

    The fallback line: Doing nothing is defending the indefensible.

    Dana (a3e680)

  9. My pet unicorn promised that when Obamacare is rammed down our throats, it will quit farting fairy dust and start farting loonies, gold ingots, and ProV-1’s.

    JD’s First Rule of Trolls … watch. Teh One is calling on them.

    JD (0a26e4)

  10. I am seeing so-called reporters spouting the Democrat talking points. When challenged on the lies, the reporters go back to the talking points and call that fact finding or double checking the facts.

    All this reminds me of when Reporter Chris Knap of the OC Register was cheerleading Robert Citron’s re-election in OC for Tax Collector and Treasurer. When challenged on Citron’s scheme to purchase reverse direvatives for increased revenue, Knap attacked the challenger. When OC went bankrupt, Editor Ken Grubbs got canned, not Knap who should have been canned.

    PCD (02f8c1)

  11. Why are you even giving Ezra Klein a forum here? If Wapo wants to hire children it’s their prerogative but we have no time for children’s games. I have a dog older than Klein.

    Life has an uncanny way of changing ones values, character, principle and opinion on the trail to maturity that doesn’t fully develop until 30 or so. I invite the youngster Klein to visit Israel to play with boys his own age to give him life experience perspective for a few years and in Israel he will get that perspective.

    Ezra, take a hike….out of Mom and Dad’s basement.

    Love,

    Sis

    Elizabeth Klein (4064c6)

  12. Liz,

    I read and cite Ezra because, as the proprietor of the JournoList, he is an excellent source for the unoffical Lefty talking points du jour.

    Karl (f07e38)

  13. All this reminds me of when Reporter Chris Knap of the OC Register was cheerleading Robert Citron’s re-election in OC for Tax Collector and Treasurer.

    A story we should never forget.

    A few weeks after the bankruptcy, Moorlach was returning phone calls to the dozens of reporters who were calling for comment. One went to veteran Register reporter Jean Pasco. Knap answered the phone. Moorlach remembers the conversation well.

    ” ‘John,’ Knap said, ‘You’re right, I missed the story.’

    ” ‘Chris,’ I said, ‘not only did you miss it, you missed the Pulitzer Prize. And I tried to help you. But you missed it. Now transfer me to Jean Pasco.’ “

    Brother Bradley J. Fikes, C.O.R. (13311d)

  14. Between Ezra and Joe … ugh. Are these the “serious people” that we are supposed to get out of the way for?

    JD (5adcdb)

  15. Ezra Klein would make a great commissar. Who knows, maybe he’ll get to be one soon.

    gp (a3af9f)

  16. Karl – Ezra has spun this POS so many different ways I think he has completely lost track of the talking points he has used. That’s one of the dangers of becoming a ventriloquist’s dummy for an Administration that can’t get out of its own way.

    daleyrocks (718861)

  17. “The fallback line: Doing nothing is defending the indefensible.”

    Yeah, yet another one of Obama’s false-choices. Unfortunately for Lord Zero, a lot of Americans are now increasingly thinking, “Hell, doing nothing–especially in a major recession–is perfectly defensible.”

    I’ll bet when Obama was a kid, during family vacations he’d drive his parents nuts with his “Are we there yet?” routine.

    MarkJ (42fe5b)

  18. Ironically, Wiki tells me Ezra Klein was born in 1984.

    Dana (a3e680)

  19. As reported today on Glenn Beck’s show:

    In assisting struggling local food banks, the USDA went out and bought millions of dollars worth of ham at $1.50/lb. to distribute to the local agencies. The same ham at a grocery store is $0.89/lb, and even less at Costco.

    So we can add an inability of the government to buy basic foodstuffs in a competitive marketplace where discounters widely advertise to the decades long list of products and services of all kinds. Yet, somehow the Obama fairy dust will be sprinkled over all government drones in the 29 new healthcare agencies and bureaus and voila! Cost cutting experts will appear at every turn.

    What will it take to rouse the American public from its stupor?

    in_awe (930ef4)

  20. Ezra Klein: so smart (just ask his friends) that he needs you to pay for his doctor bills.

    Cam Winston (96ec19)

  21. I believe in results.

    Why isn’t the VA either cheap or delivery first class results?

    Why has Medicare and Medicaid caused healthcare costs to skyrocket despite claims they would reduce costs?

    Why have states that have introduced statewide health programs seen their budgets skyrocket while failing to deliver on their promised improvements.

    In short just as Marxism makes promises it cannot keep we have American Marxists making claims they cannot deliver on yet they attack our existing syste.

    The system that is the best in the world and produces the greatest number of medical innovations each year. And they promise us leeches.

    Thomas Jackson (8ffd46)

  22. B-B-But Karl, I don’t understand…

    Greg Mankiw is a Harvard Professor man! Don’t Messers. Klein and Chait realize that being a Harvard professor grants Mankiw absolute moral authority and assigns metaphysical certitude to his opinions?!? Isn’t the Harvard pedigree one of the absolute proofs of Obama’s Brilliance!..? I wonder why that doesn’t apply to Mankiw…

    Oh, that’s right; he forfeits all of the Harvard advantages by opposing Obama policies…

    It gets kind of hard to keep these rules straight!

    Doesn’t Klein and Chait sound like a crooked law firm? No offense to any residents intended by that remark.

    Bob (99fc1b)

  23. Ezra Klein is a 25 year-old who has a political science degree from UCLA.

    Greg Mankiw has a doctorate in economics and teaches at Harvard.

    Who do you think knows way more about economics, the world and just about everything else?

    AJ Lynch (e54992)

  24. I should say that, in defense of the VA, they do have excellent programs for the elderly vets. I don’t think they are the last word in a national health care concept but they do have some good research, especially in geriatrics and in rehab for spinal cord injuries.

    Mike K (db3eb5)

  25. 13, Brother Fikes, Knap is a liar. Another view can be had from Hugh Hewitt. Hewitt knew Knap was working for the Democrat party in Orange County. The Democrat referred to by Citron and Knap was Tom Umberg. Hewitt won’t even say that name. To him he is the “U” word.

    Knap should have been fired. Pasco moved on to Spring Street where she was embraced and encourage for her life’s work of savaging GOP politicians.

    No where is mentioned then County Supervisors Chair, Bill Steiner. I was the one to talked to and confronted Steiner about the WHOLE thing.

    I know more about this story than Knap does, than Paterno does.

    Oh, in the article you cite, Tonnie Katz was the LIBERAL Business Editor at the time of the Bankruptcy. She was selected to succeed the deposed Ken Grubbs who also is ignored by the Paterno article. You want a truer perspective, talk to Ken Grubbs, too.

    PCD (02f8c1)

  26. Just to add to my 25, in testimony before the Grand Jury investigating the bankrupcy, Steiner was asked if ANYONE questioned the whole scheme. Steiner testified that I did question the scheme and that I talked to Steiner AT CHURCH about it. Strangely, I was never called to the Grand Jury. I guess that because I would dispell the whole no one knew but Moorlach scenario, I was not called.

    PCD (02f8c1)

  27. PCD,

    Thank you for that history. If I ever meet Hewitt, I’ll have to ask him about the Register.

    BTW, I just found a post nicely describing Klein at Volokh Conspiracy.

    Klein’s career has consisted entirely, so far as I can tell, of delivering himself of many opinions. In an age in which (a) the front pages of newspapers increasingly consist of precisely that and (b) the internet emerged as a forum for disseminating oneself individually and one’s opinions as a career option, he has Done Well.

    Brother Bradley J. Fikes, C.O.R. (d2e072)

  28. 27, Brother Fikes, ask him specifically about Knap. Knap doesn’t know his election law. Knap once demanded Hewitt put the “U” word on Hewitt’s KFI show because Hewitt had both contenders in the GOP Primary opposite the “U” word, and the “U” word was not brought up at all, just issues in the GOP Primary.

    Now who but a Democrat partisan would be so stupid?

    PCD (02f8c1)


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