The Doctors Get Paid.

“This is basically never mentioned in the US health care policy debate but the reason why foreign prices are lower is not mysterious — they have laws forcing the prices down. The fact that we allow such high prices is why health care in America is hard to afford. The high prices make private health care extraordinarily expensive to patients and employers, and the same high prices make it difficult for the government to cover everything through public sector insurance. Canada, where the prices are lower, manages to have a more robust welfare state without higher taxes for precisely this reason.”

As Matt Yglesias points out, one of the many reasons health care is so expensive in the United States: doctors are paid way too much. See also: 21 graphs that show America’s health-care prices are ludicrous. And after that: The Serpent on the Staff.

Along with pretty much always being on the wrong side of reform, the American Medical Association has contributed heavily to this problem. First, by working to artificially limit the supply of doctors for decades, and thus helping to ensure the doctors we do have are burdened with crushing amounts of debt. Second, by pushing for a cap on Medicare-supported residencies in 1997, further decreasing the US supply of doctors — They’ve since reversed course on that. And third, by continually skewing Medicare payment models and reimbursement rates. Don’t expect this issue to be resolved anytime soon.

Hacker: Still Alive.

“In short, it’s no time to be despondent about the fate of the public insurance option. For sure, pegging rates to Medicare and obligating Medicare providers to accept these rates would be far preferable, and a public plan with negotiated rates may do less to keep the insurers honest and drive down costs. But it’s still immensely valuable to give Americans an out — another choice — to let the insurers feel the heat of not being the only game in town. The fierce and continuing opposition of the insurance industry suggests that they think that a public option will prove a serious counterweight in an increasingly consolidated private market.”

In TNR, Jacob Hacker and Diane Archer make the case anew for a public option, specifically the one that made it into H.R. 3962. If all goes well, the House bill — recently endorsed by the AARP and the AMA — will get a vote tomorrow. (Yep, it’s a work day.) Update: Or later. Here’s the hold-up.

The Serpent on the Staff.

“As a society, we trust doctors to be more concerned with the pulse of their patients than the pulse of commerce. Yet the American Medical Association is using that trust to try to block a robust public insurance option as part of health reform. In fact the A.M.A. now represents only 19 percent of practicing physicians…Its membership has declined in part because of its embarrassing historical record: the A.M.A. supported segregation, opposed President Harry Truman’s plans for national health insurance, backed tobacco, denounced Medicare and opposed President Bill Clinton’s health reform plan.“

And don’t forget Sheppard-Towner: In his column this week, Nicholas Kristof take aim at the powerful American Medical Association. “‘They’ve always been on the wrong side of things,’ Dr. Scheiner told me, speaking of the A.M.A. ‘They may be protecting their interests, but they’re not protecting the interests of the American public.‘”