My latest essay is now out from behind the subscription wall in the Weekly Standard.

Massachusetts is considering health insurance reform to address the problems of the uninsured. The federal government is pressuring the state to do something or lose several hundred million dollars in Medicaid funding. Two competing ideas are single-payer health care, favored by some on the left, and a multilayered insurance reform proposed by Republican governor Mitt Romney.

I wind up coming out in favor of single-payer for Massachusetts. It’s not that I don’t prefer Romney’s plan in principle. It’s that Massachusetts is a state where health care spending per person is way above the national average, so that any health care finance reform is likely to look bad.

In my view, the real reason that health insurance is expensive is that medical care is expensive. The real reason that medical care is expensive is that we have so many specialists and a lot of expensive technology. Massachusetts has excessive amounts of both. You can’t fix the problem of expensive health insurance there. Try Mississippi.