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Kevin Huffman / But don't conservatives favor cost-based decision making?

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I was on Facebook the other day, yukking it up about the lamestream media and seeing which of my friends had procreated, when I came across Sarah Palin ruminating on the recent reports on mammograms and Pap smears. She wrote on her wall, "There are many questions unanswered for me, but one which immediately comes to mind is whether costs have anything to do with these recommendations."

Clearly Palin, as the leading conservative intellect, would be eager to embrace rational cost-control measures. Her keen grasp on policy issues had always been a beacon of light as I sorted out my own views. Watch out, America, we were coming out of the wilderness!

I admit that I was a little late to engage in the key issue of the day. Part of it was that most of the action happened smack in the middle of football season. But now that the moment was at hand, I was ready.

As I struggled to get up to speed on the subject matter, I was relieved to find some bedrock conservative philosophies anchoring the debate so I could get my moorings.

For example, conservatives like data-driven policy-making. As I learned about the utter lack of connection between expenditures and results in health care, I was excited to hear more about rational limits on unnecessary procedures. It's a crazy world when we spend more than twice as much per person on medical treatment in McAllen, Texas, as we spend in Rochester, Minn. - home town of the Mayo Clinic. And Texas already has tort reform!

Similarly, like most patriotic Americans, I am highly annoyed by political correctness. You can talk to me like an adult and tell me the real deal. I learned that last year, Medicare paid $50 billion for doctor and hospital bills during the last two months of patients' lives - more than the budget of the Department of Homeland Security. When we spend more on end-of-life care than on protecting the country, we obviously need to have a serious conversation. I don't need some overly PC politician telling me we shouldn't talk about death.

And no amount of liberal badgering will get me off the idea that you should buy only what you can afford and shouldn't rely on others to pay for your stuff. It's not shocking that when Americans pay out of pocket for only about 12 percent of total medical costs, they tend to consume more services, even when it makes little sense. Clearly, I thought, you can't keep asking me to pay for other people to get more and more tests whether or not they are needed!

So, when the U.S. Preventive Services Task Force made new recommendations on mammograms (mirroring studies questioning the benefits of prostate exams for men earlier this year), I was fired up to reanchor the health care debate in conservative principles. Data? Check. Evidence over emotion? Check. Telling the truth to the people? Check. Efficiency in a time of economic hardship? Check.

We were ready to turn this health-care debate around.

But then I started to get mixed up. Jon Kyl, the No. 2 Republican in the Senate, attacked the recommendations, saying, "This is how rationing starts!" Sean Hannity asked, "Is this a death panel, ladies and gentleman?" Worst of all, after watching Palin, I realized that she was actually against taking costs into account when analyzing health care procedures.

I was reeling. The cognitive dissonance overwhelmed and I looked for ways to reconcile the gaps.

Maybe it wasn't them - maybe it was me. Maybe looking for efficient data-driven approaches to vexing social issues isn't actually conservative anymore? Maybe Kyl is right, and I should be able to have as many prostate exams as I want while paying 12 cents on the dollar?

At any rate, I no longer think this is going to be our ticket out of the wilderness. I lost track of what I'm supposed to be angry about, and in the meanwhile, I also lost another weekend of football. Am I little bit disillusioned? You betcha.

Kevin Huffman, a Teach for America executive, wrote this column for The Washington Post.

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