The central health-care problem is not improving coverage. It's controlling costs...Countless studies have shown that many tests, surgeries and medical devices are either ineffective or unneeded. Greater health-care spending forfeits any superior moral claim on our wealth by slowly crowding out other national needs. For government, higher health costs threaten other programs -- schools, roads, defense, scientific research -- and put upward pressure on taxes. For workers, increasingly expensive insurance depresses take-home pay as employers funnel more compensation dollars into coverage.
Recently, I made my campaign season pledge. If I were to put it into a slogan, it would be, "we need less." In health care, the need is to cut back health care spending. In education, the need is to reduce the number of students being unnecessarily or pointlessly shoved into college. In housing, the need is to reduce the inventory of unoccupied housing units and to reduce the extent of mortgage indebtedness.
The problem is that there are bootleggers and baptists coalitions pushing in the other direction. The bootleggers are the doctors, college administrators, home builders, and mortgage securities traders who want government to subsidize demand for their services. The baptists are the do-gooders whose causes are universal health care, more higher education, and affordable housing. When the baptists are able to get you to involuntarily part with your money to support their causes, the winners are the bootleggers. (Note: the original bootleggers and baptists model deals with regulation, not spending.)