Well you have to give Chris Betram credit for trying to support the concept of death panels. I understand, but vehemently disagree, with his larger point: that ‘death panels’ are the necessary extension of the social engineering experiment that is universal health care (and by that I mean NHS-style, government-owned everything).
Afterall, without markets to coordinate supply and demand, costs will skyrocket unless rationing is carefully planned.
Betram quotes one Ronald Dworkin:
… we should aim to make collective, social decisions about the quantity and distribution of health care so as to match, as closely as possible, the decisions that people in the community would make for themselves…
I don’t buy this: if we’re just using the collective to make decisions for the individual, its because some institution(s) doesn’t – or finds it inconvenient to – believe that the individual can make personal decisions about their health care that produces optimal social outcomes (whatever this is perceived to be). Therefore, simply by making that argument in favor of employing technocrats to engineer decisions about health care in the community, and perhaps circumventing an individual’s choices, it’s a tacit admission that we think consumers are stupid about their health care.
Well… even if consumers aren’t stupid, the ‘deciders’ don’t think individual decisions (even if they are rational and informed) produce the best outcomes for society as a whole (see my lunch line post). This may or may not be true, but to support this type of socialized health care is to imply that central planners can produce more efficient outcomes than decentralized decisions in a free market. Which I don’t think anyone thinks is true. And there doesn’t seem to be strong empirical evidence to discriminate which option is more efficient than the other (except that our hybrid solution is the least efficient of all).
Maybe we should at least try free markets before assuming that they won’t be able to provide efficient solutions and insure everyone who wants to be? And, even if they turn out to be less efficient, perhaps we should go with this option anyway and accept some reduced efficiency to preserve more individual freedoms – if it does come down to “death panels”.
HT2 Tyler Cowen