There is nothing 'voluntary' about health care. Patients are not "consumers." Getting a CT scan when you are in serious pain not the same as buying cat litter. The statement that the a free market consists of "voluntary interplay of doctors, patients, hospitals, and insurers" is absurd. If anything, your argument supports single payer--a well-known and proven solution to the conundrum.

Jeff, once again, is right on the money. Those of us who opposed Romneycare and Obamacare predicted this exact result: The cost of insurance and care has shot up, as the burdens placed on those providing insurance and care have raised their costs significantly. The idea that applying price controls will solve this problem are laughable. If an insurer is told by the state that it cannot charge a premium that covers its costs, it will get out of the business. If a doctor or hospital is treated in the same vain, they too will get out of the business. The surge in costs was predicted here, and you can take it to the bank that the shortages brought on by price controls will come too.

I see you and Ron Paul have something in common -- your invoking or Diocletion economic policy. It's almost a Greek tragedy for you to turn to someone who ruled over 2000 years ago as your economic vanguard despite the moder worlds exponentially more complex economy. Notwithstanding this though, you have done nothing to prove that the "free market" has improved the cost of healthcare. The industry certainly hasn't regulated itself. And it never will. In fact it's done just the contrary to where lack of oversight and regulation has led us to the point where by 2037 HealthCare Premiums will surpass the average household income. Runaway healthcrae costs, including premium payments have becomes the biggest fiscal drag on the country and because it is a unique commodity the free market competition will never create adjustments that make it affordable. Once again you're using ideology not data or pragmatism to make your point. The facts actually matter -- something that Republicans can't seem to reconcile.

There is no doubt Mr. Jacoby depends on Heritage Foundation material for his opinion pages. Diocletian? Huh. He refuses to use more logical examples from the present developed world, that frankly surpasses us in services medically rendered and at half the price. Just as the rest of the so called "free market," the health care industry runs amok without some reasonable rules. Other developed nations, without interfering with appropriate income for its providers, have figured out how to make major headway in providing affordable access to care. Every system has its stumbling blocks, including ours, but the real tragedy in this country is that being sick causes bankruptcy, excess death, excess suffering, worker mismatch in the market place, and employer overhead excess. No one can predict if they will fall ill with any preciseness but when they do, for the average person, the bill can not be easily paid or at all. Mr. Jacoby would have you believe that nothing has changed in over a thousand years and the same lessons have the same solution. As long as we're using past thinking why not use one from an architect of this country's creation: Thomas Paine---"A long habit of not thinking a thing wrong, gives it a superficial appearance of being right, and raises at first a formidable outcry in defense of custom. But the tumult soon subsides. Time makes more converts than reason." So Mr. Jacoby is a bit behind the times as usual. It is also not clear in which century he really wants to dwell. He could help himself by studying success in the present more, instead of relying on outdated erroneous thinking. He won't because he still believes square pegs fit into round holes. Without getting outside his ideological box his thought process will remain as usual not credible.

How somebody as smart as Jeff can be so blind to the many fallacies in his own arguments is exhibit A as to why it is so difficult to get anything done with this topic. It's one thing to glibly spout off about what to do or not do. It's another thing entirely to sit down with a group of other people and create a working solution. That solution could come from the "free market" side (which of course is a total myth), or it could come from the "regulators" side, or government. There again, the portrayal of government in Jeff's picture is hopelessly simplistic and distorted. There is a long list of well-known media personalities who have made a fine living for themselves because they started in government, saw the writing on the wall, and got out. Coming up with true, effective solutions is not easy. It's much easier to sit on the sidelines and toss out all-knowing proclamations.

The Gov stated: " It's lowering premiums and maintaining quality"...HO HO HO! Sounds great, there is absolutely no proof out there that anything other than disgruntled doctors and their patients will face RATIONING, not "Quality". An amalgamation of Quasi-public agencies will enrich Dems' friends as always. Remember the Dems have created 72 "quasi-public agencies" in the Commonwealth already who are not beholden to the taxpayers, who needs another? This plan of "Accountable Care" has failed before substituting for the words "Global Payments". Folks getting a free ride will love it. Most of you will not. Since when was anyone been thinking about you on Beacon Hill? This would be an oppportune time for some Primary Care MDs who do not go to hospitals to break away and set up a "cash only" clinics offering prompt concierge service for a reasonable fee throughout the state. The Large Hospitals with the Nurses' Unions, are becoming behemoths, much like the state with its Public Sector Unions, and we all pay, as The Gov says, higher premiums than the rest of the country. Something to think about as the All-Dems legislature railroads their Global plan "Pelosi style" on the rest of us.

Just a couple of reminders this morning. Insurance companies are of course, for-profit companies. They make profit by denying care. That is a fundamentally unethical starting point. Doesn't seem to bother Jacoby. 30% of the cost of health-care in the U.S. is administrative; paid to insurance companies. Medicaid has administrative costs of 2%. Americans pay double what anyone pays elsewhere. 45 million people are without coverage. People who are misplaced at their jobs (could provide more to society through a full use of their skills and talents), are stuck in current employment because of health care. We are well past the point where our system needs a fundamental dismantling. Single payer for Massachusetts!! Drop Obama care. Medicare for all.

"Bring on the skeptics," says Walsh. OK, here's a skeptical view. 20% of us are on Medicare and can't be touched by this. 33% of us are already in the kinds of Accountable Care Organizations with global payment (Democrats used to call them 'HMOs with capitation' when they first peddled the idea 20 years ago) that Walsh promises will enable all the billions in savings for the economy and thousands in savings for families (although the real goo goos at HCFA claim the savings for families come from employers increasing your pay with the money they don't spend on your insurance!!). Over half of us are in self-insured plans and technically aren't included (see lines 1619-1623 of Walsh's bill--although certainly the self insurers won't mind if their costs come down). So that means the rest of you un-self-insured, un-old, un-capitated suckers will have to reduce your healthcare spending by 33% to make Walsh's numbers work. You think you can get the same healthcare for one-third less money?

I partially agree (this is rare) with Jacoby as I feel the state plans will lead to shortages and rationing. The state can't control the cost of pharmaceuticals, medical devices and the other things that go into patient care. These costs rise at a much higher rate than the GSP. They, despite what they say, have no way to measure or ensure quality. As usual one thing that actually might bring some savings is completely off the table. The senate and house plans are based on the prime directive of American healthcare: The health insurance industry must be preserved at all costs even if patient care suffers. The money that goes to support the insurance industry is completely wasted. Add in the huge costs providers bear to support the insurance industry massive administrative demands and you have a lot of money being flushed down the toilet. But we can't consider that so bring on shortages and rationing.

the basic falacy that clowns like Jacoby sell over and over is this concept of "health care" vs "health insurance". Rule number 1. People get sick! 2. they need health care! 3. they get treated regardless of inusrance. 4. if not insured someone has to pay. 5. that someone is us. it's beyond idiotic to assume otherwise and even more so not to plan for the inevitable. And really Jeff, what Cato/Heritage web site did you get your talking points this time. Diocletian? What episode of Star Trek was that.

Put this one in the "JJ Hall of Fame" for it's reliance on conservative nonsense arguments(government always bad/free markets always good) and for reaching back nearly two millenia to illustrate his non-point.

Does Jeffy really believe that we are better off trusting our health to the 'bureaucrats' of the insurance companies, HMO and big Pharma? Once again, is Jeffy deliberately and knowingly prevaricating, or just too intellectually disadvantaged to comprehend the true facts? In words the tea partiers will understand, is he lying, or just stupid? Maybe he, and those who agree with him, should move to another state where they will find themselves at the mercy of a predatory health care system. He can't be denied care because of pre-existing conditions, or because of a disease that costs too much to cure. It's easy to throw around the pejorative term "nanny state', when one conveniently overlooks the good that actual nannies do in the world.

You should get sick and die alone in the cold and dark.

You should die in great pain, alone and uncared-for in the cold and dark.

On almost any subject, Jeff Jacoby doesn't know best.

The state religion of Massachusetts is Statism. Although there is no Pope, per se, statists believe in their well intentioned heart-of-hearts that the State is infallible, and can shame, cajole, fine, imprison, condemn and embarrass the market to do its will. Can't wait for the worship services at the soon-to-be constructed George Clooney Basilica on Beacon Hill. I understand the iconography there will be magnificent.

To those of you who believe in the power of price controls, should we bring back rent control? God, that made housing affordable for everyone, right? BY my recollection, the waiting time for rent controlled units was in the years, and the wealthy and politically connected were able to jump to head of the line. Is that how we want health care rationed?

Excellent point, my friend. I can remember when the housing stocks of Boston and Cambridge were deteriorating because of local rent control laws.

Poor Jeff. He still thinks that the "free market" should be allowed to freely fleece the masses. Why sure, we'll simply rely on the for-profit insurance companies to do the right thing and help rein in costs as opposed to maximizing their own proft margins! I'm surprised he didn't include the "Nanny state" label to shame the state for watching over the welfare of its citizens. Yet its not real surprising. Conservatives have always championed the "right" of private companies to set their own rules (Wall Street anyone?) while objecting to government intrusion in free enterprise even when said enterprise amounted to nothing more than usury and fraud. Maybe the Roman emperors had the right idea after all...

Yet another clueless paean to the glories of unfettered corporations from the intensely irritating Jeff Jacoby. I am surprised he didn't get a dig in about the evils of illegal immigrants or how this is really a dastardly plot on the part of Muslims to destroy our healthcare system. Ah, well, there's always next week.

Well, if any of that were true all of the elderly would be out in the streets. Clearly Medicare works just fine and one large reason is that 30% of the money isn't siphoned off by insurance company executives.

You should have the same decent health care that any citizen of a civilized state should receive, but you should also concern yourself with health care policy in Virginia, and leave us liberal extremists to deal with health care policy in the great state of Massachusetts without unsolicited input from right wing extremists in the heart of Dixie.

This pearl from a rich man who will never worry about whether he and his family will need life-saving health care that they can't afford. Corporations and their stockholders should not get rich on denying healthcare to poor and middle-class people.