Friday, March 11, 2011


Paul Krugman, Ezra Klein, Matt Yglesias, Jonathan Cohn, Jonathan Chait -- everybody today wants to know why right-wingers don't like comparative effective research, and why folks like Mike Huckabee say it leads to "death panels." All CER does is test different treatments to determine whether various medical conditions can be treated at lower cost with satisfactory effectiveness. Given the fact that the government pays for a lot of health care -- Medicare, Medicaid, etc. -- that could save taxpayers a lot of money. Why is that bad?

Chait, I think, comes closest to the the correct answer:

I think [a] factor at work here is just very simply -- ideology. Conservatives do not believe that the government can rationally measure effective and ineffective treatments and steer funding away from the latter to the former. Or, rather, they begin with the premise that the market is the answer, and reject any solution that doesn't involve the market. Comparative effectiveness research is a solution to health cost pressure that involves bureaucrats. Therefore it can't work.

I think it's a lot simpler than that. Conservatives know perfectly well that CER can work. They also know how ridiculously easy it is to demonize. It involves bureaucrats! Overeducated bureaucrats! And overeducated scientists! The scientists do things ordinary people can't understand! And then the bureacrats prepare policy papers that ordinary people also can't understand! And all this is paid for by tax dollars!

It must be elitist wasteful spending! It must be social engineering! Done by overeducated people who probably drive hybrid cars! So it must be ... socialism! Which is like Nazism! Which also involved the government telling helpless people what they had to do!

Really, that's the point: It doesn't matter what conservative opinion-formers actually think. What matters is what they can sell to the rubes. They want to sell the notion that everything Democrats do is evil. And they dwell on this not because they really, really hate it, but because it's really, really easy to make the rubes hate it.

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