The word among professional Democrats is that John Edwards has set the stakes on the matter of health care, and no one who wants to be president can offer less than he is offering, which is -- of course -- guaranteed health. That is to say, guaranteed free health care.
Mr. Edwards' primary complaint is that 47 million Americans do not have health insurance. In a free society, one scans this datum in search of its component parts.
If health insurance were without cost, one assumes that everyone would have health insurance. A corollary of this is that everyone, in a society of allegedly free health care, would actually be paying the collective costs of health care. The political challenge lies in disguising the cost.
When a commodity is quantifiably measurable, yet universally available, like air, one can talk about its being "free". Only people in submarines need to measure air, and to pay the cost of supplying it. Health care, unlike air, can't be free, because doctors and nurses and drugs are not in infinite supply. So can we generate what amounts to a public subsidy by reducing the costs of health care?
To look that problem in the face, we search out relevant figures. One set of these reveals that the cost of health care for an American is twice what it is for a Western European. If in Germany it costs $100 per day per patient at a hospital, while a comparable hospital stay in the United States costs $200, one reaches for an explanation. Is it that American health care is twice as expensive because it is twice as comprehensive, twice as resourceful? Or is it simply that, for other reasons, doctors and nurses and drugs cost twice as much in the United States?
In any case, how do we go about reducing these costs? Either you pass a law that doctors and nurses and drug companies have to slash the cost of their services and products by one-half -- a proposal nowhere hinted at by Mr. Edwards -- or else we need to reduce the number of people entitled to receive that health service. How do you do that?
Not by going in the direction proposed by Candidate Edwards, but by going in the opposite direction. His proposal is that more people should be covered. But if more people are insured, they will increase their consumption of health care, and therefore increase the total U.S. expenditure on health care.