One other bit of McMegan’s post that bugged me was her elevation of single-payer as goal in and of itself, as if what interests reformers isn’t the health of the populace or the sustainability of the system but the aesthetics of the financing structure. “Look at that funding mechanism,” we’ll one day whisper in awe. “It’s just so redistributive.”
You get this occasionally from libertarians, and it’s always struck me as an availability bias error: Because the shrinkage of government is an end unto itself for them, they assume the expansion of government is an en unto itself for liberals. Liberals are just libertarians, but backwards, and without the “rtarian.”
That, however, isn’t true. Liberals want greater public involvement in health care because they’ve concluded the profit incentive doesn’t create optimal outcomes in this particular case. You can’t comparison shop during a myocardial infraction. You can’t walk away from the table while on a gurney. You don’t want to be in the position of second-guessing your doctors. You don’t want your neighbors going bankrupt because they failed to adequately save in their HSAs, not suspecting they’d get cancer at 32.
Health care isn’t like flat screen televisions — if I don’t have the former, I can die. If I lack the latter, I’ll be watching Entourage in slightly lower definition. On the other hand, I really wouldn’t want the government taking over the provision of flat screen televisions, as there the market works pretty damn well. The relevant variable isn’t the economic theory, but the good in question.