Wednesday, October 22, 2008

Samuelson: None So Blind

Because Robert J. Samuelson's column, "Young Voters, Get Mad" is desperately in need of one. Plus some basic honesty. His column begins:

To: Voters Under 35

Subject: Your Future

Recommendation: Get Angry

You're being played for chumps. Barack Obama and John McCain want your votes, but they're ignoring your interests. You face a heavily mortgaged future. You'll pay Social Security and Medicare for aging baby boomers. The needed federal tax increase might total 50 percent over the next 25 years.
"Social Security and Medicare." If there's one phrase that is a dead tipoff that a 'centrist' pundit is lying to you, that's it. Conflating Medicare and Social Security as fiscal problems is like lumping together North Korea and, who knows, maybe Monaco as foreign-policy problems.

Social Security is a non-problem. The trust fund whose purpose is to insure the baby boomers is currently expected to run out in 2049, when most of them will be dead anyway, and when it does, the revenue stream from the existing payroll tax will pay for benefits that are as good as beneficiaries get today.

Here's what to do about Social Security: check back in 10 years to make sure any problems are still decades away. And in the meantime, deal with pressing challenges like climate change, health care, jobs, the economy, education - real stuff.
There are three basic ways of reducing the costs of Social Security and Medicare: increase eligibility ages; trim benefits; and require recipients to pay more for their Medicare benefits (higher premiums, co-payments or deductibles). In his talk, Obama effectively rejected all three.
And good on him. Medicare is a problem, because in America, health care costs for everybody keep on going up. But that's unique to America, among the advanced democracies.

Once, just once, I'd like to see a WaPo pundit seriously consider what other countries in our peer group, so to speak, are doing to keep health care costs in check. Because as Ezra Klein points out in "The Health of Nations" (read it if you haven't), they're doing a damned good job of it, while providing pretty good care to everyone. And they're doing it in a variety of different ways. The main thing that seems to save money, as Ezra notes here, is integration.

Unified systems that handle all aspects of health care for a particular group of people don't have the tremendous inefficiencies that pile up at every step of the way in a non-system like ours, where "it's your insurance company negotiating with an urgent care ward that sends you to a hospital who prescribes a follow-up with a private specialist who tells you to pick up a prescription at the drug store of your choice which gives you a reaction which sends you to the emergency room which then puts you in touch with yet another private specialist," to quote Ezra again.

Even domestically, private integrated health care systems like Kaiser Permanente and public ones such as the Veterans' Administration do a much better job of containing costs than the rest of the health care sector does. And across the pond, entire nations that have single-payer systems pay 40% to 60% of what we do on health care, per capita, to cover everybody.
There can be no "rewriting of the social contract" without benefit cuts, because paying today's benefits inevitably involves much higher taxes, massive deficits or draconian cuts in other government programs. Even with sensible benefit cuts, taxes will have to rise and there will be pressure on other programs.
The problem is, we've got a screwy health care system that's unlike what anyone else in the world has. And Samuelson isn't even aware of that. He pretends to write knowledgeably about this topic, apparently without having ever stuck his head out of the U.S. and seeing how the rest of the world works, without ever getting an clue of just how abnormal and dysfunctional our system is by comparison.

Samuelson is ignorant. Ignorance can be cured, but one has to pull one's head out of one's ass first.

One more thing:
People live longer; they can work longer.

Many of us can work longer. I sit at a computer all day; my work doesn't tax my body at all. I can work a long time.

My father-in-law spent most of a lifetime crawling around industrial refrigeration units. By 62, his body was worn out and used up. If he'd had to work until 65, I'm not sure he'd have made it. Plenty of other people on the bottom level of our service economy are on their feet all day - waitresses, the people who change the sheets and towels in hotel rooms, the women who clean and empty the wastebaskets in my office building, and the like. Just because they live longer, doesn't mean their legs don't give out just as soon.

I doubt that Samuelson even sees these people as they do their jobs, though he surely benefits from their labors. He clearly doesn't think about them. In his mind, people like him are typical. But they're not.

As the saying goes, there are none so blind as those who will not see. And there are few better examples than Robert J. Samuelson.


MR Bill said...

And, perhaps, if workers had comprehensive health care, then a lot of them might just be able to work longer.
But silly me, we have a war and a bailout of rich bankers to pay for...

low-tech cyclist said...

Exactly - you gotta get those priorities in line! What's more important - bailing out rich bankers (there was something in the WaPo this morning about how the bankers were going to use the money to buy up other banks, rather than make loans and unfreeze credit - great dealmaking, Hank!) or providing health care to working Americans?