George Bush blew his chance to reform social security by proposing changes that did nothing to address the out-of-control costs of the program. His proposal for private accounts went down to defeat. Similarly President Obama’s (or Congress’) health care proposals do nothing to address the out-of-control entitlement programs (Medicare and Medicaid).
Either a European style system, where care is rationed by queuing or by treatment, or a market-style system with big deductibles or co-payments, where care is rationed by price, would control costs. The point is that we have neither. There is no mechanism in either the status quo or the various Congressional proposals to control costs, and this is the legacy of the Greatest (and now Obama's) generation: we lack the political courage to ration care.
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