Non-original thoughts on health-care

Reading through Ezra Klein's morning discussion on health-care raises what to me is the fundamental problem with the left-wing health-care argument. (See, I'm fair to Klein. He might know less than nothing about food, but health care he seems to understand something about, and I do not).

So Klein says that the goal is to reduce national health care expenditures - what I understand as the aggregate spending on health care in the entire country, public and private. And the way to do this, I understand him to believe, is to use so-called "public option" to reduce costs. Fine.

As others have observed, I assume that Klein does not think it is a good idea to organize other parts of our economy in this way. After all, you can make exactly the same arguments about car production, and yet no one would say that we should reduce our national expenditure on cars by having government produce standardized cars with lower, negotiated prices. I recognize that smart people have constructed arguments about why the health care market is different, but I confess I do not completely understand them. But the left argument is dependent on the truth of this proposition.

Even granting the proposition, the bottom line really is that I do not believe there is an appreciable surplus of real waste in private sector healthcare as opposed to the public sector. I suspect, though cannot prove, that the reason national health care expenditures are lower in other countries are a combination of much lower compensation for health care professionals, lower drug costs, much less extraordinary care, and lower creature comforts in hospitals. I would assume an honest liberal would say all those things are true and are the proper cost for ensuring health care for all. Beware anyone who does not grant the truth of those propositions.

I think the left has to face up to the fact that getting universality of coverage and lower aggregate costs means persuading people who already have insurance to accept worse service or higher costs for their current level of service. I don't think they have done this forthrightly.

Still busy

The topic of the U.S. Senate and its undemocratic nature (and more specifically, whether that undemocratic nature is a problem) is usually the bailiwich of Professor Levinson at Balkinization, but I wanted to flag a recent decision by the highest German court effectively delaying German ratification of the Lisbon treaty, a much maligned bit of legislation designed to further bind Europe together.

I haven't had the time to read the document entirely, and it is in a stilted translation of assuredly already stilted legal German. Nonetheless, I found the the following of some interest. The German court held that the Lisbon treaty as it was currently constituted violated the Basic Law. Why? Because a single German representative in the European parliament represented far more people than his or her colleague in Malta or Sweden or any smaller country:

"According to the Draft decision, a Member of the European Parliament elected in France would represent approximately 857,000 citizens of the Union and thus as many as a Member elected in Germany, who represents approximately 857,000 as well. In contrast, a Member of the European Parliament elected in Luxembourg would, however, only represent approximately 83,000 Luxembourg citizens of the Union, i.e. a tenth of them, in the case of Malta, it would be approximately 67,000, or only roughly a twelfth of them."

But is this always a violation of general democratic principles? No, said the German court. Just in a representative chamber of government:

"In federal states, such marked imbalances are, as a general rule, only tolerated for the second chamber existing beside Parliament; in Germany and Austria, the second chamber is the Bundesrat, in Australia, Belgium and the United States of America, it is the Senate".

The Court's decision implies all kinds of interesting things, but, alas, I must run. Perhaps later.