CONSUMPTION.(The Talk of the Town)(medical care)

Perhaps you have been wondering who or what is to blame for the high cost of medical care in this land of ours--and, more broadly, for the ungainly, unjust mess that is the American health-care system. If so, wonder no more. Your government has fingered the culprit: it's "the vast majority of Americans."

The perp having been collared, the trial held, and the verdict rendered, only the sentencing phase remains. Providentially, our leaders have come up with a punishment that fits the crime. We, the guilty, are to be condemned--or invited, but in any case for the rest of our natural lives, without possibility of parole--to turn over our bodily well-being to "consumer-directed Health Savings Accounts" in conjunction with "high-deductible health policies."

This judgment was handed down last Monday, in the form of an article on the Op-Ed page of the Times. The piece was no Dowdy jestfest or Friedmanesque memo-to-the-mullahs, and not only because of the dreariness of its style and the banality of its content. Its author, Allan B. Hubbard, identified as "assistant to the president for economic policy and director of the National Economic Council," has lately emerged as the White House point man on health policy, and, in subsequent days, his Op-Ed proved to have been the overture to a veritable symphony of spin conducted by President Bush himself, including an Air Force One ride to Bridgeport, Connecticut, for a stagy "Panel on Health Savings Accounts."

Hubbard's article, headlined "The Health of a Nation," begins with a frank-sounding acknowledgment that "in the past five years"--that is, since the present Administration took office--"private health insurance premiums have risen 73 percent," with the result that "some businesses" have dropped coverage altogether. "What is driving this unsustainable run-up in health insurance costs," Hubbard asks, "and how can we make things better?" Then comes what bloggers call the money quote:

Health care is expensive because the vast majority of Americans consume it as if it were free. Health insurance policies with low deductibles insulate people from the cost of the medical care they use--so much so that they often do not even ask for prices.

Can this really be the Administration's view of the health-care crisis? That its root cause is that Americans are (a) malingerers and (b) freeloaders who perversely refuse to go comparison shopping when illness strikes? That we're overinsured? Hard as it is to believe that this is what they say, it's even harder to believe that this is what they believe.

Health care is indeed expensive, but not because people are too quick to call the doctor when they experience a scary symptom or merely an annoying one, and not because some of them may bridle at entrusting their health to the lowest bidder. Throughout the Western world, health care is expensive, first of all, because it is expensive, and is bound to get more so as populations age and medical technology advances. Indeed, it should get more expensive, both in absolute terms and as a proportion of national income, because what it aims to provide--healing, the relief of suffering, the staving off of death--is of such inestimable value.