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I feel fine today. Thanks for asking! But what if I weren’t? Then I’d have to go to the doctor. And that would cost a lot of money. It wouldn’t cost me a lot of money, mind you, but it would certainly cost someone a lot of money. Probably MoJo, which is too bad since they have lots of better uses for their money than paying huge sums to insurance companies for their employees’ aches and pains.

It would be nice if we could pay less. Unfortunately, as Ezra Klein points out, Democrats and Republicans have come to opposite conclusions about how to do that. Democrats, quite sensibly, point out that private insurance is the most expensive kind of healthcare there is, so perhaps we need more government involvement. Republicans, who are ideologically opposed to more government involvement, insist that Medicare is the big driver of high medical costs, even though there’s no actual evidence for this. Ed Kilgore is despondent:

Beyond that, the arguments can get confusing. Sometimes Republicans seem to identify health care inflation strictly with rising public costs; shifting those costs to beneficiaries, from that perspective, “solves” the problem. Other times Republicans appear to believe that over-utilization of health care is the only real problems in the system; thus, exposing patients to more of the costs generated by their demands for care will “bend the curve” of health care costs. More direct reductions of costs via the use of the government’s leverage “distorts markets” and can’t, according to conservative dogma, possibly work.

How do you find a “compromise” between people with such diametrically opposed ideas of how the health care system works? Beats me.

Well, it’s a good question, all right. Roughly speaking, if you place the rich countries of the world on a scale from most government involvement to most private involvement, you find countries like Britain and Canada at one end, and they spend the least. You find countries like Switzerland and the United States on the other end, and they spend the most.

Now, it’s almost certainly true that if we switched to a purely private system and eliminated standard healthcare insurance as we know it, we’d end up spending less. This is the “skin in the game” theory, and it means that if we all had to pony up full cost whenever we visited the doctor or got an MRI, we’d pay a lot fewer visits to the doctor and demand lower cost MRIs. The problem, of course, is that this idea is universally hated and will never happen. This leaves Republicans in a quandary. It’s really the only idea they have, but they can’t seriously propose it because they’d probably get kicked out of office for the next 50 years or so. Their solution, in practice, is to (a) propose watered down versions of this idea hidden under enough layers that maybe no one will notice, and (b) relentlessly oppose every other idea without really offering any alternatives of their own. Remember “Repeal and Replace”? We never did hear much about the “Replace” part of that, did we?

Will this stalemate ever end? Probably someday. But not soon.

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AN IMPORTANT UPDATE

We’re falling behind our online fundraising goals and we can’t sustain coming up short on donations month after month. Perhaps you’ve heard? It is impossibly hard in the news business right now, with layoffs intensifying and fancy new startups and funding going kaput.

The crisis facing journalism and democracy isn’t going away anytime soon. And neither is Mother Jones, our readers, or our unique way of doing in-depth reporting that exists to bring about change.

Which is exactly why, despite the challenges we face, we just took a big gulp and joined forces with the Center for Investigative Reporting, a team of ace journalists who create the amazing podcast and public radio show Reveal.

If you can part with even just a few bucks, please help us pick up the pace of donations. We simply can’t afford to keep falling behind on our fundraising targets month after month.

Editor-in-Chief Clara Jeffery said it well to our team recently, and that team 100 percent includes readers like you who make it all possible: “This is a year to prove that we can pull off this merger, grow our audiences and impact, attract more funding and keep growing. More broadly, it’s a year when the very future of both journalism and democracy is on the line. We have to go for every important story, every reader/listener/viewer, and leave it all on the field. I’m very proud of all the hard work that’s gotten us to this moment, and confident that we can meet it.”

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