What Steuerle says about Medicare represents one point of view, but there’s another take, too, which was not part of this NPR discussion. Its omission gave listeners a lopsided picture of Medicare’s troubles. So I rang up Yale professor emeritus Theodore Marmor, who wrote a seminal book called The Politics of Medicare and who sees Medicare very differently. “Some analysts believe that using medical care is like buying bread—the more you get, the more you want. That is true only of hypochondriacs,” he said. “By repeating this interpretation again and again, these analysts act like marketers imagining that saying so will make it so. But that isn’t so, as the experience of other countries illustrate. The reason Canada spends less per capita on medical care is not because of the way it raises funds, but rather the way it controls its expenditures.”
Marmor pointed out that there are “two dramatically different ways of approaching Medicare.” One, he says, presumes that medical care is like other industries subject to market forces. The other relies on the experiences of other industrial democracies, which use the countervailing power of government to restrain inflation. “These are incompatible positions,” he explained, “and any reporter should be aware of how incompatible they are and to understand both.” The public needs to understand both, as well. NPR’s segment did not help.