Prescription for Change

Ailing Health Care

Paul Krugman, apparently convinced that the Social Security debate is all but over, has moved on to health care. Today he starts what he promises will be a weeks-long effort to explain what he thinks we ought to do to fix our bloated, expensive, and inefficient health care system. He says he'll explain how the wonderful innovations that continue to make health care more and more expensive can be harnessed in a system that costs less and provides better care for more people.

And he's up-front about how this will be achieved:

To get effective reform, however, we'll need to shed some preconceptions - in particular, the ideologically driven belief that government is always the problem and market competition is always the solution.

The fact is that in health care, the private sector is often bloated and bureaucratic, while some government agencies - notably the Veterans Administration system - are lean and efficient. In health care, competition and personal choice can and do lead to higher costs and lower quality. The United States has the most privatized, competitive health system in the advanced world; it also has by far the highest costs, and close to the worst results.

This should make for a very interesting next few weeks.