Quoting Jonathan Cohn, "it's important to defend the virtues of comparative effectiveness research." Yet:

Everybody knows that our health care system is full of wasteful spending. There's the waste from administrative overhead and the never-ending hunt, by insurers, for healthy beneficiaires [sic]. There's the waste from unnecessary, even harmful, medical services. If we could eliminate even some of that waste, it should free up a great deal of money--more than enough to subsidize insurance coverage for those people who can't afford it already. Get rid of the waste, in other words, and we can pay for universal health care. But it will take many years to pinpint and then reduce most of that excess. That means the government must find some other source of money to pay for universal coverage, at least for the time being.

Maybe, just maybe, there isn't enough money or enough human knowledge to solve all of America's problems during Obama's presidency. How about we give money to the NIH and others to spend on a lot more research about which drugs and medical services are most cost-effective, and then we revisit the universal coverage debate? Such research would be a public good, benefiting hospitals, private health insurers, and government health insurers like Massachusetts and Medicare.

We already have state and federal funding of the health coverage of poor children and retirees (poor or not). Poor adults get free emergency-room health care. If there's truly a moral imperative to provide health coverage for poor adults, then surely there is some less important government spending that can be redirected towards this end? Perhaps we could start with means testing for Medicare. Given who's in power, the money actually would come from a tax increase, but in any case, coverage for poor adults is a lot cheaper than universal coverage.