The bolded sentence demonstrates the problem with Brooks' argument. He is positing that one should not trust "studies" because they only represent preconceived worldviews. However, I would argue just the opposite. The only way to determine which system would be better for Medicare would be to look at empirical evidence, and as I demonstrated in my last post, all the of the statistical evidence points to Medicare doing a better job than private insurance of controlling health care costs.
The fact is, there is no dispositive empirical proof about which method is best — the centralized technocratic one or the decentralized market-based one. Politicians wave studies, but they’re really just reflecting their overall worldviews. (emphasis added) Democrats have much greater faith in centralized expertise. Republicans (at least the most honest among them) believe that the world is too complicated, knowledge is too imperfect. They have much greater faith in the decentralized discovery process of the market.I’d only add two things. This basic debate will define the identities of the two parties for decades. In the age of the Internet and open-source technology, the Democrats are mad to define themselves as the party of top-down centralized planning. Moreover, if 15 Washington-based experts really can save a system as vast as Medicare through a process of top-down control, then this will be the only realm of human endeavor where that sort of engineering actually works.
Brooks' alternative to looking at the specific evidence relevant to Medicare is to make the obvious point that most of the US economy is a market-based system. But Brooks goes too far when argues that there is no part of the economy where a top-down (government) system works. Does Brooks drive on federal funded highways? Is he protected by the US military? Of course. Quite simply, while most services are better provided by a free market, there are a few services (highways, defense, health insurance for the elderly) that the government has proven that is does a better job of providing. Ironically, Brooks is the one relying on his preconceived worldview, not the "study waivers."
I agree with Brooks' column in one regard. The current Medicare debate is about where wisdom lives: careful study of empirical evidence or abstract philosophy.