Pun Salad

The subtitle: "Rethinking How We Pay For Health Care". The author, Arnold Kling, is one of the libertarian bloggers at EconLog; he's also an adjunct scholar at the Cato Institute, who published this book back in 2006. It's short, 87 pages plus front- and end-matter. Although Arnold's an economist, it's written very accessibly for the lay reader. To use an old cliché: he tells you what he's going to say, he says it, and then he tells you what he said.

Arnold ably lays out the issues; although the book is four years old, all of the same issues confront us today; in fact, they've been made even more painfully obvious. Key is his deft presentation of the trilemma confronting anyone daft/hubristic enough to redesign the "health care system". Principles that "must" be satisfied:

• Unfettered Access. Consumers must be completely free to select any treatment that the health care provider and patient agree would be beneficial.

• Insulation. Consumers must be protected from the financial and emotional burden of paying for health care procedures. They should have the security of knowing that health care will be provided by private insurance and/or government.

• Affordability. The health care system must not absorb an inordinate amount of resources. Health care spending should not crowd out more valuable public- or private-sector needs.

Still, there's always a chance that we could come to our senses and start looking for saner solutions to financing health care. Arnold's policy suggestions are modestly stated, but in fact would vastly improve our future: shift responsibility for health care spending back to individuals; allow innovative health-care insurance products that might provide access to high-cost care more efficiently; consider deregulation of the provision of health care.

All it would take to start down that path are honest and courageous politicians… oh, wait.