Markets vs. Morality

      David Brooks argues in his latest column that the main difference between the Republican and Democrat models for health care reform is top-down vs. bottom-up planning.  Really, argues Brooks,

"Politicians wave studies, but they’re really just reflecting their overall worldviews. Democrats have much greater faith in centralized expertise. Republicans (at least the most honest among them) believe that the world is too complicated, knowledge is too imperfect."

      Jonathan Cohn finds this merely new spin on an old Republican framing:

Brooks writes as if the key distinction between Democratic and Republican plans for Medicare is the way they would manage the program, with Democrats entrusting experts to make key decisions about where to spend money and Republicans entrusting consumers. But that’s not the most salient difference between the two approaches. The most salient difference is that Democrats would preserve Medicare's fundamental guarantee of health benefits at affordable prices. Republicans would not.

     I completely agree.  This is less about markets and more about morality.  One of the most irritating conservative mistakes is to compare private vs. government service without acknowledging the fundamental point of government services: to guarantee some standard of access to all. Private enterprise is pointed to as routinely superior in service – which it no doubt usually is. But be they roads, parks, libraries, schools or health care – they are not required to open their doors to everyone. Of course this is often less efficient, and normal market mechanisms won’t come to bear – but we make this sacrifice if we feel the service is of sufficient importance to provide to the public.

     Has “public service” lost its meaning?