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Kuttner Versus Kling: Two Prescriptions for Health-Care Reform

Local Matters


Published April 22, 2009 at 10:42 a.m.

Most everyone agrees the U.S. health-care delivery system is ailing. An estimated 50 million Americans don’t have any coverage, and millions more are under- insured. In Vermont, roughly 136,000 people went without health care last year. About 85 percent of those people have jobs.

Two starkly different visions of reform will be presented in a debate this week at the University of Vermont. Robert Kuttner, co-founder and co-editor of left-leaning mag The American Prospect and founder of the Economic Polity Institute, a nonpartisan think tank, will argue in favor of a single-payer system. Arnold Kling, a former senior economist at Freddie Mac and adjunct scholar with the Libertarian- leaning Cato Institute, says individual consumers should be in charge of their health-care destiny.

While the final outcome of their approaches differ, Kuttner and Kling agree that President Barack Obama and Congress should improve the health of the economy before mending the broken U.S. health-care system.

They also agree on two other key issues: The current system is unsustainable and leads to costly procedures foisted upon the public as necessary.

On cost, the Center for Medicare and Medicaid Services estimates we shell out $2.1 trillion annually on health care — or about $7000 for every man, woman and child in the country.

Kuttner argues marketing, profits and billing account for up to $500 billion of that spending, divvied up chiefly amongst insurance providers, hospitals and pharmaceutical companies.

“We have a system that is badly fragmented and pays too much money on middle men,” says Kuttner in his case for a single-payer system such as those that operate in much of Europe and Canada.

Kling counters that single-payer is no panacea. “Medicare is the fiscal equivalent of the Titanic and the coming deficit is the iceberg we all know is there,” said Kling. “’Medicare for All’ is like saying, ‘Let’s put more passengers on the Titanic.’”

Rationing, HMOs, deductibles, golden parachutes — St. Albans Messenger Publisher Emerson Lynn will moderate the debate between the two heavy-hitting health-care experts. It can’t hurt to hear them out.