The Lowden Medical Plan

Democrats are having a lot of fun with Sue Lowden, the Republican candidate for U.S. Senate from Nevada. Her plan for health care reform - repeated by the candidate when the laughter first began - is for Americans to take chickens and other produce to their doctors and barter for care. Seriously!

She's apparently not the only Republican who's confused about what century this is, either. But as a serious candidate for the U.S. Senate, she's getting the most attention. Here's how Josh Marshall at TPM puts it:

This does put the Nevada senate race into a certain clarifying perspective. The Health Care Reform bill wasn't Harry Reid's bill -- ideas and strategy from lots of people went into it. And many people had endless criticisms of how he managed the process over the course of 2009 and 2010. At the end of the day, though, it passed. The Senate is where it happened. And Reid was central to the entire thing. That is an historic accomplishment. If his career in politics ends in January, his place in history will be secure.

So on the one side you have Harry Reid, a key architect of comprehensive Health Care Reform, the product of decades of activism, in all its messiness and policy complexity.

And on the other you have Sue Lowden, who thinks bartering livestock and other commodities for health care services from doctors is a way to rein in spiraling health care costs. (If you think that's an exaggeration, take a minute and watch this video.) There's no end of comedic possibilities thinking through the logistical and logical difficulties of managing co-pays and long-term care and drug costs in chickens and other barter payment. But step back and give it a serious look and ... well, this is this woman's take on confronting medical inflation. It's funny and also sad. But as a contrast it's stark and painful.

Seriously, think about it for a minute. 

Yes, seriously, just think about that. Nevadans, please think about that! Check that video of Sue Lowden "doubling down" on her barter idea. This wasn't a slip of the tongue. It's really the only thing Republicans have to offer for health care reform (certainly now that they've refused to support a bill that is essentially Republican in the first place, just because it was proposed by Democrats).

As I noted, Democrats are having a lot of fun with this. Here's Sue Lowden's Chickens for Checkups, where you can send a letter to the candidate requesting her help looking for a doctor (for rickets, the vapors, and other old-timey ailments) who will take what you're willing to barter (chickens, goats, indentured servitude).

Apparently, it's not just the official Democratic Party, either. Here's the Lowden Medical Procedure to Chicken Converter, where you can calculate the number of chickens you need to bring to the doctor for various procedures (for a flu shot, you must take the doctor 5 chickens, according to this; for hip replacement surgery, 6,549 chickens).

This handy calculator converts many common procedures into chickens so you won’t look like an idiot at your next Doctor’s Appointment.

And there's a guy in Reno trying to trade a chicken for a heart transplant, on Craigslist.

But Nobel Prize-winning economist Paul Krugman explains why this would be dumb even without the chickens:

Sure, it’s funny to see a 21st-century political candidate pining for the days of a barter economy. But her remarks would have been breathtakingly ignorant even if she had called for payments in cash.

The key fact about health care — the central issue in health care economics — is that it’s all about the big-ticket items. Checkups don’t cost much; neither does the treatment of minor illnesses. The money that matters goes to bypasses and dialysis — costs that are highly unpredictable, and that almost nobody can afford to pay out of pocket. Modern health care, if it’s going to be provided at all, has to be paid for mainly out of insurance.

Conservatives don’t like this; if few of them propose paying in chickens, there is nonetheless a constant refrain of calls for making the market for health care more like the market for bread, with consumers paying out of medical accounts and engaging in comparison shopping. There is, for example, vast romanticizing of things like Lasik and cosmetic surgery, which are held up as models for health care as a whole — even though they’re actually very poor models. (They’re discretionary and fairly cheap — not at all like the procedures that dominate health costs in the real world.)

Why this preference for cash? Because even conservatives know in their hearts that insurance markets are deeply imperfect, which means that standard free-market arguments become very weak once insurers are involved. And so they pretend that we don’t really need all that insurance.

The business with the chickens adds an additional level of absurdity. But Ms. Lowden’s perspective is ludicrous even without the feathers.