How Is Kaiser Permanente Not Like Walmart?

Timothy Noah has an article in Slate today about health care reform, in which he laments the fact that, according to a recent poll, Americans are more afraid of the government having a larger role in determing what medical treatments people receive than they are of the role played by insurance companies. He writes:

The discouraging finding concerns a question that [the Kaiser Family Foundation] doesn't appear to have asked in previous polls. In his July 22 press conference on health reform, President Obama parried a question about the prospect that the government would ration health care by saying:

[T]he government already is making some of these decisions. More importantly, insurance companies right now are making those decisions. And part of what we want to do is to make sure that those decisions are being made by doctors and medical experts based on evidence, based on what works. Because that's not how it's working right now.

It's a powerful point: Wouldn't you rather decisions about your medical treatment were made by government-paid medical experts, focused on which treatment may help you get better, than by private insurance companies focused on maximizing corporate profits? Granted, once a treatment is approved, the government would probably pay less for it than a private insurer would. But, ultimately, government is answerable to the public. Insurance companies are answerable to their stockholders.

As often happens when I read Noah on health care reform, I was a bit boggled by this. Let's try a slight substitution:

Wouldn't you rather decisions about what types of cereal are available be made by government-paid consumer research experts, than by private retailers focused on maximizing corporate profits? ... Ultimately the government is answerable to the public. Retailers are answerable to their stockholders.

Now, it is somewhat clear (or so it seems to me) that medicine isn't really acting in the normal market way. This is probably because of the ways it's regulated already (e.g., the way we get insurance through our employers without paying taxes on it). So we can't really just choose a better insurer as freely as we can choose to stop in a different store. And, honestly, I don't want health care to just be a completely free market, because I think that would (overall) be worse instead of better. But it is certainly not obvious (and is quite possibly not true) that having the government decide what you can and can't have is going to be nicer than having a variety of private companies making those same decisions based on a contract between you and them.

Noah concludes with this even more bizarre assertion (emphasis added):

The larger point, though, is that evidence is growing that even the seemingly bumbling intervention by President George W. Bush's treasury secretary, Henry Paulson, helped the United States avert the onset of a second Great Depression. President Obama's maladroit stimulus probably helped, too. The same may be assumed of legislation that would increase government control over medical decisions. If it doesn't help, voters can make their legislators change it. What their legislators can't do is protect them from the rapacity of private health insurers should no health reform be enacted.

I guess we may assume, then, that any and all government intervention will "probably help," since growing evidence suggests that the bumbling and maladroit stimulus bills did. Perhaps the government really should step in and take care of that breakfast cereal issue. After all, if it doesn't help, we can make legislators change it, while what the legislators can't do is protect us from the rapacity of, well, Walmart.