Jay Morris

Mark, you started by saying we have no idea what healthcare costs to buy or to provide in this country. None. Then your conclusion is to propose that the people who cannot see the costs should be the ones to run it. There is a reason nobody knows what anything costs, and you listed it yourself. Medicaid, Medicare, supplemental plans, Medicare Advantage, self insured employers under a tax code that hides the premium in the paycheck. Every layer you named is a government program or a government created structure, and in every one of them the person getting the care is not the person paying for it. That is where the price went. Prices exist where buyers pay. Remove the buyer and you get exactly the fog you are describing. Universal care removes every buyer who is left. Then look at what you are asking for. Every private contract in the industry published by federal order. Every claim in the country handed to state and federal researchers. The DOJ turned loose on the pricing structure. Bipartisan legislation to work out what care we need to provide and what it should cost. That is not a market reform. That is the state seizing the information of an entire industry so it can set the terms of trade for every doctor, hospital, and patient in the country. You call the conglomerates Too Big To Care. The entity you want running it is the only one with a monopoly on force. And the number. The post you are replying to has CBO at $3 trillion a year in new federal spending, 21.4 percent of payroll, with the author conceding it is illustrative and not scored. You respond that nobody knows the real cost and we should find out after we commit. No investor you have ever met would fund a company on those terms, and you have never funded one that way yourself. Only government gets to spend money first and discover the price later, because only government can send the bill to people who did not agree to it. The information asymmetry you are describing is not a reason to negotiate blind. It is a reason to stop having a single buyer negotiating at all. Put the patient back in the transaction and prices appear on their own. Cost Plus is proof that you already know this. Mises showed a century ago that a planner without prices cannot calculate, Hayek showed why the knowledge he needs is never in one place, and Rand showed why he has no right to try. You are proposing to prove all three wrong with a commission while you admit no one has any idea how much all of it will cost. Do you think they did not know what they were talking about, or do you just not want to find out?