September 10, 2007

One would think that the august New England Journal of Medicine, whatever its other myriad failings, would be able to recognize obvious inconsistencies in its own arguments. And one would be wrong. So very very wrong. I refer this time to the editorial in the September 6 issue, in which John K. Iglehart summarizes the state of play of the battle in Congress over SCHIP reauthorization.

Iglehart notes in several places the issue of precisely what income level would cap the elgibility of families for SCHIP "coverage," never asking precisely what government-funded health insurance "covers." Everything? Not in this world, a reality with respect to which Iglehart is oblivious, particularly when he refers to a provision in the House bill that "would repeal the sizable reductions (10 percent in 2008 and 5 percent in 2009) in fee-for-service payments to doctors that Medicare is scheduled to implement on January 1." This obviously is an attempt to buy political support for the House bill.

But does Iglehart, or anyone at the NEJM, recognize the deeper point, to wit, that the expansion of government funding inexorably expands also the imposition of price controls as a means of "cost" (i.e., spending) control? Apparently not; and that is the real manifestation of myopia, as government "coverage" of children or anyone is nothing of the kind, as "cost control" today necessarily yields rationing and a long term decline in the supply of medical services and technology. There are no free lunches in the Beltway or anywhere else.

Posted by Benjamin Zycher at September 10, 2007 09:06 AM

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