The decline of David Brooks:
He looked silly when he initially called Paul Ryan's plan "the standard of seriousness", but now he's gone further in attempting to promote it.
In a New York Times column
this week, Brooks claims Ryan's plan is probably superior to all the others because it's not
a top-down, centralized system. Boo, top-down systems!!
But the advantage of a top-down approach in many cases is that it consolidates economic interests
, resulting in greater bargaining power. There may be some inefficiencies as a result, but in many cases it's more advantageous to be a single large economic entity than to be an atomized set of tiny ones.
The numbers bear this out, at least in health care, if you compare systems throughout the world - which Brooks does not do
Also, Brooks touts the Medicare-D program as spending less than projected - which Ryan attributes to "consumer choice", but which is due to (a) fewer people enrolling in the plan, and (b) many drugs going off-patent, causing costs to go down for all plans everywhere.
The Brooks column has triggered a number of skeptical/derisive posts: Ezra Klein
, Kevin Drum
, somebody at the Economist magazine
, Jonathan Cohn
, Jonathan Chait
, Bob Somerby