Matt on rationing

Link here

Similarly, your kid is entitled to go to a public school. They’ll teach him reading and writing and some science and history and probably Spanish or French or some such. But in the vast majority of places, you can’t have your kid taught Japanese at taxpayer expense. Again, though, we don’t live in a dystopian universe of “language rationing” in which it’s impossible to learn Japanese, you’d just have to pay someone else to do it. We of course could ban the market in private foreign language instruction, but it’s not clear why we would do that, and the existence of public sector provision of Spanish language instruction doesn’t in any sense imply a ban on the teaching of other foreign languages. What’s more, even if you’re incredibly troubled by the fact that today’s poor children don’t have the chance to learn Japanese in public school it’s still the case that eliminating public schools and lowering taxes isn’t going to leave those kids any better off. They still won’t know Japanese and now they also won’t be able to read.


Francois' response: that's a great point, but there's a key difference. If there's one thing I've found from talking to Canadians and Brits and Swedes about health care, it's that since medicine is complex, they are ignorant about what's covered and what's not. Most just assume that it's all covered. Which is convenient for the governments involved, but is really deceptive. It would be like the government telling citizens that all the learning they'll ever need they can get from public schools, so people don't bother to read books(or blogs).

But public schools don't work that way. The available curriculum is easy to find and is available to all to see what they have and what they don't. So you know that if you want your kid to have Japanese lessons for an upcoming trip, then you need to pay for those yourself. Likewise, with private insurance, you can go on the internet and they'll tell you what is covered and what is not as it pertains to RX drugs. I've tried to do this for NHS or Canada's Medicare. I've failed. That doesn't mean it's not available, but it does mean that someone can't just casually log on to the website and find out what is covered easily.

In order for that analogy to hold up, Democrats need to lay out, in writing, what is covered and what is not on a public plan. Otherwise, they are tricking people into thinking they are getting the best health care possible when in fact there might be better treatments available that aren't covered. One of the advantages of a system where everyone has different insurance, is that doctors generally prescribe whatever is best. If the insurance company comes back with a "hell no", then they can look for an alternative, or the consumer can figure out how to get the money. In a system like the NHS, the doctors operate from a presumption that what the NHS covers is what the patient can get and often don't tell them all their options. They use the guidelines as a bible. The same thing would happen under a public plan if it became the predominant form of insurance.