Scare tactics may be the favored means of killing the general public's support for real health care — omgz they're gonna take away your doctor and make you see a bureaucrat who will let you die because you had to wait 6 months for your bypass operation —but that nonsense won't work with most members of Congress (the ones not cheating on their wives in Jesus). To sucker people with a modicum of intelligence on the subject requires an ability to misstate facts and possibilities in a way that sounds rational while making "reasonable" alternatives — ie, not changing a damn thing — more attractive.

The key to tricking people with reasonableness is to use words, phrases and concepts that are not explained but carrying sufficient data to carry a point that, if scrutinized properly, would prove unreasonable. Taking as given certain "facts" — that health care insurance, provided by profit-driven corporations, is always going to be part of any system — is also important. The key is to avoid digging into the real reasons for why the entire system is broken and taking the entire economy down with it.

Here's an excellent example from today's New York Times:

How would insurers lower prices and raise quality? By passing their incentive along to doctors and hospitals. To maximize their revenue from insurance companies, doctors and hospitals would need to provide better care at a lower price — something they can accomplish only by squeezing out error, waste and inefficiency.

The amazing system that is touted as a great example is in Danes County, Wisconsin, and features both the state refusing to pay full cost for the program (patients pay for anything above the program's ceiling) and the inclusion of HMOs. How can this work? Easy: it "impose[s] a stern and lasting discipline on our insurance market — and at the same time insure[s] everyone, provide excellent benefits and offer abundant choices." In effect, the state-run system, which the authors sees as a model for their "public option", low-balls insurance bidders, takes the lowest bid and any costs above what the state system pays is out-of-pocket for enrollee. The refusal by the state to pay above a certain amount, while allowing the insurers to charge the insurees for the additional costs, is the "discipline" that fixes a broken system.

What makes the system in Dane County work is not market-based disciplined by the presence of the government. Period. Minus that involvement, the HMOs continue in the same old way. The government steps in to regulate, which is supposed to be the most anti-market thing possible, and the market somehow begins to work wonderfully well.

The authors argue that the biggest problem with health insurance providers is a lack of market-oriented discipline. For normal folks, this is known as greed. The same companies can, they argue, be forced by "the three most essential market forces — choice, competition and incentives — to reduce the price and improve care." But choice and competition already exist, and the one incentive that might work — getting creamed by a public option that does not have greed (ie, profit) built into the system — is ruled out for one very simple reason: it's run the government.

By stating unequivocally that a government-run plan is going to be inefficient and wasteful — that the "at best, it would misuse the government’s power to set prices without getting at the underlying errors, waste and inefficiency in America’s overpriced health care system" — the authors take as a given that the public option the President is promoting is a non-starter. They do not debate why a public option of that sort is bad; it just is. Because it's the government. And the government can't do anything but hurt market-based insurers.

But the health insurers in America know nothing about the market. They play, as the authors note, with no concept of market forces. They gouge and gouge without any market discipline whatsoever because they can extract profit to the extent they desire. But a system that has no profit incentive within it — a corporation-free public option — is a bad thing because ... it hurts corporate insurers.

Yet somehow the same government that won't be able to provide quality health care minus the profit-driven corporations will be able to force the same profit-driven corporations, which, of course, give millions of dollars in campaign "donations" to the members of Congress who would write the rules overseeing a government-enforced discipline system? Excuse my cynicism, but I fail to see how the latter magically works when the former can only fail.

But that's the nature of this game: Take as a given that a government-run public option, minus the corporations, can only fail because government can no nothing well, then after that, any alternative works. Utter the magic words — Market discipline! — and all is well. Forget that corporations always find a way to get around government regulations to find new ways to take maximum profit; it's the magic of the marketplace we need, not reform.

That's sick.