Ezra Klein, high priest of the Church of Universal Coverage, kindly concedes the point that government — including Medicare, America’s experiment with universal coverage — tips the scales toward fee-for-service payment rather than prepayment.

But in case that scale-tipping actually hurt anybody, he exonerates government and pins the blame on the physicians who got government to do their bidding:

I’ll happily admit that it may have thrown up some roadblocks. But that one’s not really on government — it’s on the medical profession itself.

I’ll respond to Klein with what I told Paul Krugman and others at a recent debate:

The industry has way too much influence when the government gets involved. And it’s nice to think that we could have this wonderful universal coverage plan, and we could just get the industry out of it; we could just not have the industry be a part of it; we could cut off their influence.

But we know that the industry’s always going to be around. We know that there’ll always be drug companies and greedy private health insurance companies. And Republicans who will mess things up like they messed up FEMA and they mess up everything else. So you can’t say that universal coverage is this wonderful idea and we can separate out this part.

This is an inherent part…all the rent-seeking from the industry, and all the buffoonery from the Republicans. Unless you have a plan to abolish Republicans, they’re part of your plan.