The newly reinvigorated advocates of a “public option” in health care argue that government, with its limitless deep pockets, with its ability to sustain an economically unviable operation indefinitely through its taxing and borrowing power, provides fair and meaningful “competition” to private health care providers and insurers. Well, then, why not have private providers compete with government across the entire range of government services? Maybe the supporters of actual market-based competition in health care could offer the following deal: We’ll give you your health care public option, now open garbage collection, road-building, transit operations, mail delivery, parks maintenance, education, sewage treatment, prison management, inter alia, to private sector competition, and let the most efficient player win.
(I do not, by the way, believe that even an appropriately deregulated market in health insurance will succeed in lowering health care costs significantly over the long run. As long as people retain their desire to sustain their own or others’ lives long beyond what our biological shelf-life is naturally programmed for, human ingenuity will create ever more fantastic and expensive new technologies and drugs for doing so. The Fountain of Life does not come cheap.)