Dr. Goolsbee's article is a far more fair airing of critiques against Sicko than I'm used to hearing from Slate -- the free-marketeers here tend to be more orthodox than he and, in my opinion, less well thought-out in their critiques of alternatives.

However, in classic Slate style, he rests his critique on a bit of a straw man, arguing against Moore's prescriptions for altering the US system. Whether one gives Moore the handicap that it's hard to explain complex issues even in the best of movies or not, he's hardly the first person to propose this, and Sicko is hardly the most complete manifesto and thoroughly designed and described plan out there. While I understand hanging the article on Sicko as a draw -- it's current, Moore's controversial, and Dr. Goolsbee can still appear contrarian by being the anti-anti-contrarian: saying he genuinely likes Moore, unlike so many at Slate who hasten to distance themselves from him, regardless of whether a given point he's made is valid or not. But arguing against a movie's plan for a single-payer system, even a documentary (or whatever one wants to sling at Sicko as a label) is hardly the most engaging mental exercise, and if Goolsbee wants to conclude that a single-payer government system is the wrong answer, he shouldn't contain his critique to a movie. Being an academic, you'd think he'd want to bring in primary sources at some point, explicitly.

In the end, Goolsbee ends up implicitly endorsing both sides of the issue: "I couldn't help but think that we've got ourselves a Beige Bomber of a health system. A lot of stuff goes wrong with it, but to replace the whole thing would cost a hell of a lot of money. Moore thinks the car is already broken down beyond repair. The metaphor isn't perfect, though, I realized after I left the theater. All cars have to be replaced; our health-care system, if improved, could live for a very long time. And so we shouldn't forget that Moore is glossing over the huge costs of an overhaul, in his urge to rush."

All cars have to be replaced. Goolsbee makes a major economics boo-boo by ignoring the proper calculus here: is paying the metaphorical $300 to periodically fix the "beige bomber" going to end up costing more, or less in the long haul than buying a new car now? Is it worth pushing the inevitable upfront costs of a new car into the future, or is the possibility of a major breakdown -- thousands of dollars instead of hundreds -- large enough that it's better to invest in a new car sooner rather than dolling out bits of many ad infinitum, until we're forced to buy a new one anyway?

And when we're talking health care, these $300 aren't just dollars -- they're human lives and health. If our system has the equivalent burning oil or has a slow leak like an old car, the jalopy is actually burning people, as it were, and leaking the poor and uninsured. Goolsbee should know that, and should've addressed it. Typical Slate sloppiness in what would otherwise be a decent story.