If the Median Economist Set Health Care Policy
By Arnold Kling
Contrary to Arnold, I think it would be a vast improvement over the status quo. I’ve talked to plenty of left-wing economists about this topic. On balance, their views are much more reasonable than the median non-economist’s.
The median economist might be someone like David Cutler or Jonathan Gruber.
Bryan thinks that the median economist would raise deductibles on government insurance, impose means-testing on Medicare, and deregulate medical practice to some extent. Perhaps the median economist also would allow health insurance to be sold across state lines–eliminating the impediments imposed by having different insurance regulators in all 50 states and the District of Columbia. If so, then all of these would be good things. But I am not sure that the median economist would do these things.
Things that a median economist would do that I would like:
–Cost-effectiveness research (Bryan implicitly mentions this)
–Eliminate the tax differential between employer-provided health insurance and individual insurance
Things that a median economist would do that could be dangerous:
–Try to deal with health care costs by setting health care provider compensation policy in Washington
–Address the alleged problem of adverse selection in health insurance with regulations on the supply side (not allowing health insurance companies to take risk into account) and a mandate on the demand side.
Things that a median economist would not do that I would do:
–phase out Medicare by gradually raising the age of eligibility
–replace Medicaid with a voucher system
–completely deregulate medical practice
Maybe Bryan is right, and that the median economist’s policies would be better than the status quo. I am not sure. Actually, I think a lot depends on how well the median economist learns from mistakes. If we can assume that the economist figures out that setting compensation policy in Washington is a bad idea, and so eventually gives up on that approach, then I become more optimistic about having the median economist be in charge of health care policy.
Bryan also could argue that even though the median economist would not adopt the policies that I favor, the median economist would be much more open to them than the median voter.
I think I have to give this round to Bryan.