Recent articles in Dissent on health care (Winter 1994 and Spring 1994) have been valuable but add up to less than might be hoped. Not so long ago it was often true that one could predict the left’s position on just about anything: the more state/public control, the better; and the closer to total equality, the better. Through long controversies and even more due to the massive force of political events, most currents on the left turned both claims into questions. The resulting inquiries have been appearing in the 1990s in broad discussions about relations between public authority and markets, the complexity of equality, the importance of taking account of distinctive features of different social goods, and so forth.
Faced with a debate as sprawling and critical as that underway about health care, however, the subtlety of these discussions seems to have been put aside in favor of familiar positions: the more public authority over health care, the better; and the more fully equal provision, the better. Thus debate on the left seems to presume that a single-payer system is the best way to organize health care, leaving for argument only whether some form of managed competition is an acceptable compromise on the way to that solution....
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