Following on this post from ealier this week in regard to American’s currently failed system of health care finance, Arnold Kling follows with another one:

. . . Kling’s Iron Trilemma. We want:
–what I call insulation, where consumers enjoy the peace of mind of having their medical services paid for by a third party;
–unrestricted access, where consumers and doctors can choose medical procedures without bureaucratic interference or government budget limits;
–less stress over rising health care costs.
The trilemma is that we can have at most two out of three. Much of the “reality-based community” (an Orwellian label if there ever was one) denies that the trilemma exists. [Jonathon] Gruber [the M.I.T. economist who helped design the universal health insurance plan in Massachusetts] does not deny its existence, but he prefers restricting access to reducing insulation. I prefer the latter.