Dissing Edwards by supporting American health care

New rule of thumb. People who don't support John Edwards will often try to downplay the significance of the fact that he has a platform. A big, detailed platform. The rule of thumb is: Those people are either Republicans or Obama supporters.

Anyhow, from that rule of thum comes this post from Richard Posner about the (obvious) need for health care reform. It starts:

The early Presidential campaigning season is replete with complaints, discussions, and proposals concerning the health care system, widely regarded as broken. Democratic candidate John Edwards has proposed a comprehensive reform that he calls "Universal Health Care through Shared Responsibility"

Although the Edwards plan is commendable for its detail and clarity, there is an element of fantasy in Presidential candidates' proposing detailed, specific reforms, on any complex issue, so far before the election; for the feasibility of reform depends on economic and political conditions, including the political makeup of Congress, when the President takes office.

This critique is, I guess, fair enough. Edwards will probably not be able to get all of his reforms through. And it would be foolish to support John Edwards in the hope that John Edwards' will save the world by diktat. I'm quite sure Edwards doesn't think he's going to do that. But what he is doing is still significant. By challenging the stasus quo with politically daring proposals, Edwards is broadening the acceptable terms of the discussion on an impressive range of issues. And that is the only way real change, even if it's slow change, will happen.

Anyhow, it's pretty clear (both because he's Posner and because of the ridiculous things he says about health care) that Posner is a Republican. Or Republicanish. There are a thousand and one problems with Posner's take, and I've tasked Ezra with dismantling the whole post in a technical way. But note this from the end:

The second way to reduce aggregate health costs would be to force down the price of treatment by exercise of the government's potential monopsony power. Suppose all doctors were employed by the government. Then their wages would be low because if you wanted to be a doctor, as many people do, you would not have any alternative to accepting the government's wage. Of course the quality of care would decline. Or suppose (and this the tendency toward which some of the current proposals are tending) that the government bought all the drugs that are produced, having forbidden the drug companies to sell to any other purchaser. Then the price of drugs would be much lower than it is today, but so would be the quality, since the incentives for innovation would be diminished by the lower price.

This comes at the end of a post defending the market as the proper mechanism to make health care efficient and high-quality and yet it rests on the flimsy supposition that things the government manages and pays for should  a priori be assumed less efficient and not-as-high quality. This has literally--in health care and in other industries--never been a safe assumption to make. Governments, after all, have the power not just to lower the cost of things, but also to funnel those savings into incentives that prevent quality from suffering. Ignoring that fact is a perfectly fine way to scare people into accepting a broken health care system, but is unfortunately not a particularly helpful way to fix any problems.

There's also a false choice here--either your doctors are employees of the state or employees of industry and in no way can they be both. There are examples of health care systems that make private insurance illegal. And there's our system wherein almost no doctors work for the government. But in between there are all of the best health care systems in the world.