Do You Actually Want Competition or Not?

On Saturday, Rep. Roy Blunt delivered the Republican response to the president’s radio address, and focused his remarks entirely on health care – specifically, the arguments against the public competitor at the heart of Obama’s plan and likely the main fault line in the health care debate in Congress.  A big hat tip goes to Maggie Mahar on Health Beat Blog who points out the breathtakingly obvious logical inconsistencies and mutually exclusive assertions of his argument.  If you listen closely, you can actually hear the fecal matter being thrown against the wall to see if it sticks.

The rationale of the public competitor is, as its name suggests, is steeped in the most free-market of values:  competition.  If public coverage similar to Medicare is truly going to be more efficient, cheaper and lead to just as good a result, let’s put it up against private insurance plans for those who purchase individual coverage through Obama’s National Health Exchange.  Jacob Hacker, the originator of this idea, believes the competition could well be good for both – preventing public coverage from ignoring ease-of-use for its “customers” or cutting reimbursement rates to nothing on providers, and encouraging private insurance to, basically, stop being such a schmuck, lest it get kicked to the curb.

But because so many of the talking points against universal health care presume a single-payer monopoly, conservatives have to bend over backwards to attack a policy that espouses their value.  Blunt practically has to do yoga – he’s all for “competition” but the competitor will push out the private plans.  Uh, if it does so, that’s called “winning the competition,” Roy – just ask Barnes & Noble.  But no, wait, the public plan will be terrible, like a DMV on acid or like the worst post office (in a related story, the U.S. Postal Service just came out #1 for most trusted government entity in the U.S. for the fourth year in a row in the Ponemon Institute study – you can’t make this up!)  Now, you might ask, how can a terrible service crowd out better services in direct competition?  But no, Roy is off to something else – rationing, that’s it.  But surely, if you had a choice between an Aetna plan that doesn’t ration and a public plan that does, wouldn’t Humana win?  No, wait, because government always gets the price wrong.  Reading through this address is like the Cretan’s paradox – the act of competition is non-competitive.

To which I say, Congressman, you must chill.  You either are for competition or against it.  You can’t be both at the same time – we call that talking out of both sides of your mouth.  But gosh, if Congressional Republicans aren’t going to give it the old college try!