I was once on Bill O’Reilly’s Show. Another time, we sat next to each other at dinner (as fellow contributing editors of PARADE, the Sunday supplement). He was perfectly cordial both times. But he has a temper. I’d not seen these 90 seconds before. Charming.
As advertisers flee O’Reilly’s show, he retains at least one prominent endorser: the President. Donald knows Bill well, he says, and doesn’t think he’s done anything wrong. (Do it with a Tic Tac, and who really has grounds for complaint?)
But a presidential endorsement is not what it once was.
“Meet The Press” commissioned a survey to find out how people would feel about a product endorsed by President Trump. As you may have seen Chuck Todd report yesterday morning, a full 18% said the endorsement would be effective: they’d be more likely to use the product knowing it had Trump’s seal of approval. But 49% said his endorsement would make them less likely to use it, with more than half those going further: 29% of all respondents said they would actively boycott the product.
I’ll tell you whose endorsement would mean a lot to me: Fareed Zakaria’s.
For me, “must-see TV” includes Fareed Zakaria every Sunday morning on CNN.
And here’s a surprise. He thinks Trump has for a long time, until very recently, been right about something really important.
As he began last Sunday’s show:
The recent Republican debacle on healthcare could prove to be an opportunity. You see, it’s highlighted yet again the complexity of America’s medical system, which continues to be by far the most expensive and inefficient in the advanced world.
But Donald Trump could actually use the legislative collapse to fix healthcare if he went back to basics and to his core convictions on the topic, which are surprisingly intelligent and consistent. Really!
There is an understandable impulse on the right to assume that healthcare would work more efficiently if it were a free market, or a freer market. It’s true for most goods and services. But in 1963, the economist Kenneth Arrow, who later won a Nobel Prize, offered a simple explanation as to why markets would not work well in this area.
He argued that there was a huge mismatch of power and information between the buyer and the seller. If a salesman tells you to buy a particular television, you can easily choose another or just walk away. If a doctor insists that you need a medicine or a procedure, you are far less likely to reject that advice.
Every advanced economy in the world has implicitly acknowledged this argument because they have all adopted some version of a state- directed system for healthcare. Consider the 16 countries that rank higher than the United States on the conservative Heritage Foundation’s index of economic freedom.
All have universal coverage and state-driven, guided or operated systems. Hong Kong, often considered the most unregulated free market in the world, has a British-style government-run system.
Switzerland, one of the most business-friendly countries, has a private insurance system just like the United States, but found that to make it work, it had to introduce a mandate like Obamacare.
I am particularly struck by the experience of Taiwan, which canvassed the world for the best ideas before creating its system. It chose Medicare for all, a single government payer with multiple private providers.
The results are astonishing. Taiwan has achieved some of the best outcomes in the world, while paying only seven percent of its GDP on healthcare compared to 18 percent in the US.
I asked William Hsiao, an economist who helped devise Taiwan’s model, what lessons they took from the United States.
(BEGIN VIDEO CLIP)
WILLIAM HSIAO, ECONOMIST: You can learn what not to do from the United States rather than learn what to do.
(END VIDEO CLIP)
ZAKARIA: Americans often assume that despite its costs, American healthcare provides better services than others. For example, we often hear about the waiting time for care in other countries, but according to the Commonwealth Fund, among industrialized countries, the US is in the middle of the pack for wait times behind even the United Kingdom.
Trump has now taken up the call to repeal Obamacare. But until recently, healthcare was actually one of the rare public policy issues on which Trump had spoken out consistently for 20 years. In his 2000 book, the America We Deserve, here is what he said:
“I’m a conservative on most issues, but a liberal on this one. We should not hear so many stories of families ruined by healthcare expenses. We must have universal healthcare. We need, as a nation, to re-examine the single-payer plan as many individual states are doing.”
[10:05:04] Trump was right on this issue for much of his life. He has recently caved to special interests and ideology, unmoored by facts. He should simply return to his convictions, reach out to the Democrats and he would help America solve its healthcare crisis.
Zakaria and Trump are both American born Muslims (except for Donald), both magnificently educated deep thinkers (except for Donald), both courtly and unfailingly gracious (except for Donald) — so, okay, sure: they could hardly be more different. Could they? Yet on health care, until Trump’s recent flip, they both quite sensibly come out the same place as the rest of the civilized world.
Quote of the Day
Governments are necessarily continuing concerns. They have to keep going in good times and bad. They therefore need a wide margin of safety. If taxes and debt are made all the people can bear when times are good, there will be certain disaster when times are bad.~Calvin Coolidge
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