Suspicious of fixes for affordable housing and health care

by Wade Rathke

November 19, 2021

New Orleans    A headline that promises to offer a “fix” for those of us who want affordable housing and healthcare has to rate as a “must read” in my book, but that’s just what seemed on offer in the New York Times. Reading the piece was also a short course in how difficult in our times of division it is to reliably parse the polarity between right and left, Democrats and Republicans. It was difficult not to believe that the authors associated with something called the Niskanen Center, named after an advisor to President Ronald Reagan and former chair of the reliably conservative Cato Institute, don’t lean somewhat hard to the right, but it’s important to keep an open mind about even a conservative institute that claims to be concerned about questions of poverty and welfare as a problem rather than a target of abuse, repression, and derision. Furthermore, anytime even a libertarian kind of outfit that is still going to be okay with its director of programs in that area using the Twitter handle @hamandcheese is going to get at least a read from me.

In a spoiler alert, basically the authors, Sam Hammond, Mr. Ham and Cheese, and Daniel Takash, a professor at John Hopkins, believe that to achieve the aims of the Democrats social welfare infrastructure objectives, they need to attack the regulatory regime. They attach affordable housing and health care reform to that star by arguing that restrictive zoning regulations are depressing building of new housing, which on a supply-side Reganesque argument is their case for affordability, and on health care the restrictions on non-doctors performing more services they would have us believe would lower medical costs. There’s no question that there is some merit in their position, even if their claims are far fetched about the outcomes, especially on affordability. California has moved now to restrict single-family housing zoning in order to allow more multi-unit construction across the state. Various upgrades in nursing skills including the creation of physician’s assistants have already come to many major hospitals, and they make a difference. There is no sign yet that any of these steps have lowered costs.

I’m sympathetic to their argument that there are too many pieces in the bill that subsidize the middle and upper classes on child care, tuition and other costs without dealing with underlying structural issues, resulting in a temporary price relief without being needed reform. They don’t comment on how hard, if not impossible, real reform would be. They call this “cost disease socialism” which is a guarantee that their argument will be divisive everywhere except among the heavy breathers among their backers, which is too bad. There’s merit in some of their presumed concerns.

They admit that they can’t pretend that costs aren’t an issue. They scold their Republican friends for showing too much antagonism to all regulations, admitting that many are in fact necessary, but while doing so they still don’t make the case that any of this will create lower costs. They want to believe that the market will fix all of this, but don’t offer any evidence for where or how that’s happening.

The rest of us will have to keep on working and hoping for real fixes for affordable housing and accessible health care.


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