Wow. So Michael Kinsley sat down last night, fired up his sardonic-left-wing-rhetoric generator, and let fly with a Slate column on health care that...makes no sense at all, as far as I can tell. For some reason, he's against single-payer health insurance. Here is his explanation of why single-payer is a bad idea:

What's different about health insurance is the opposite: Much of it isn't insurance at all but a subsidy. The value of the subsidy is the difference between what the individual pays and what the insurance would cost in the free market. If people were buying health care or insurance with their own money, they might or might not spend too much—whatever "too much" is—but no one else would need to care if they did.

A subsidy has to take from someone and give to someone else. Everybody can't subsidize everybody. Or, to put it another way, society cannot give the average citizen better health care than the average citizen would choose to buy on his or her own. And this is what people want.

I don't really understand what Kinsley is trying to say here, but I'm pretty sure it's totally wrong. And baffling. This construct of the "average citizen" whose decisions to buy health care "on his or her own" must, axiomatically, equal the total health care purchased by the polity, divided by the number of citizens... This just seems like complete nonsense. If every American were required to buy, say, national defense individually, how many nuclear-powered aircraft carriers would result? Zero, obviously. (Unless maybe Rupert Murdoch decided to really go on a binge.)

As for the distinction between "insurance" and "subsidies"...this is a totally bizarre distinction. Insurance, obviously, is a subsidy: it is the subsidy of the unlucky by the lucky. We do it because 1. none of us are entirely sure that we or our children won't wind up unlucky, and 2. societies which treat all of their citizens AS IF they might just as easily have been lucky as unlucky, end up with happier and more productive citizens, and are simply better places to live. Anyway, what people want to get through single-payer isn't better CARE than the average citizen would choose to buy on his or her own; it's better COVERAGE. And that is easily attainable - in fact, the simple fact that it is universal renders it in that crucial sense superior to any individually purchased coverage, because it is guaranteed, regardless of whether you lose your job or become impoverished.

This isn't a zero-sum game; changing the system changes the whole landscape of available assets. Just like anything else in economics. But especially in health care. To give one example: Kinsley worries about more people wanting access to $100,000-dollar-a-year pills. But with most pills, doubling the number of people taking them makes it possible to cut the cost of the medication drastically, because the additional production cost of an extra dose is often negligible. The expenses are all for the overhead. In fact, after paying off initial capital costs, the price of the pills might drop to $100; so the more people we insure and treat, the faster we can start saving money. Kinsley's whole reductive way of thinking about these problems is ridiculous - if I understand him at all, which I'm not confident I do, because it's such a weirdly written piece.

I have a feeling I've seen Kinsley do this before - try to look at some complicated economic problem through the college-sophomore lens of adding up all the assets, dividing them out, and positing that whatever comes out must equal what goes in. Of course, real economic and social problems are vastly more complicated than that; what comes out almost never adds up to what went in. But what a totally weird thing for him to write - and at this moment...?