Bill,
The libertarian model for health care might solve the problem of cost (and I'm pretty dubious about even that), but it won't solve the problem of access. People with money will get health care. People without money won't. People with no money don't participate in markets. Either we provide for them, or they do without. If you want to create a health care system that will shut out a large proportion of the American people, that's fine. Just say so.
The good part about Cochrane's horribly written and mostly incomprehensible essay is that he focuses upon the ridiculous inefficiencies in our current system. In that way, he and Gawande are on the same page, and the degree to which those inefficiencies can be reduced, through market reforms or the application of business models or anything else, is laudable.
I'm always amused by the fantasy world that academics, both left and right, live in., Very Smart People, as Krugman likes to call (as if he isn't a member of the group!) dream up ideas, write papers, give conferences, and otherwise beat their gums proposing solutions that have zero, zip, nada relation to the reality of the world around them, In Cochrane's case that world lies just on the other side of the Midway. They have no model of previous experience, no hypothesis that can to be tested, no real data to support their assertions, just a bunch of passionately held ideas that they verify mostly by talking to each other.
And these ideas he wants to unleash upon upon a nation of 300 million people as his laboratory. Thank G-d he'll never get the chance.
Blood pressure high enough for you?
Eli
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