When you have a substantial inefficiency, you also have a whole bunch of people whose jobs depend on that inefficiency. That’s why it’s hard to treat coal the way we should and that’s why it’s hard to treat Sallie Mae the way we should. It’s also an important reason why “Medicare for All” isn’t really the political no-brainer that people sometimes claim it is—insurance companies employ tons of people, the vast majority of whom are not cackling and evil executives.
Now at the end of the day, I don’t think policy should be made on that basis. The best path, over the long-run, to ensuring good jobs for all Americans is to have sustainable prosperity built on economic growth. And that means accomplishing our public sector tasks in efficient ways—no needless subsidies to private student lenders, no teachers who stay on the job no matter how badly they do, no unnecessary health insurance company middlemen taking a slice of all our spending, no Medicare payments for useless or harmful treatments, etc. But all of this stuff is very challenging to do in part because of special interest money but also in part simply because behind every instance of waste stands someone whose livelihood depends on the waste.
(my bold for emphasis)
Hey, I'm one of those livelihoods! Since a private payer pays my salary -- and, to some extent, since I'm not convinced that fully-government-controlled anything is the best direction -- I stand behind those evil corporations and lobbyists who strive to prevent Single-Payer Health Care. Conversely, my job security is also one of the big reasons why I favor the recent incarnations of the health care reform bill: They leave the private market - and all the employees who work for them - very much intact.
This much is lost on both fringes.
The Party of No is so blindly hell-bent on preventing "the full takeover" of our Health Care sector that they're railing against a far, far less sinister proposal. The Progressives, on the other hand, are so adamant that the only way to lessen the cost of care for everyone is to let the government run the whole show that they completely discount the millions of people employed by insurers. People who, as Matt Y points out, aren't exactly millionaire CEOs.
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