What Would Happen If the Median Economist Controlled Health Care Policy?
By Bryan Caplan
On health care, the irrational public–the ones that want government to
keep its hands off their Medicare–is helping to fight the Progressives
who want to impose a health plan that is based on what I see as a
failed model–the Massachusetts plan. In Bryan’s ideal world, wouldn’t
our health care system be run by the wise technocrats of the Obama
In my ideal world, we’d recognize that economists’ textbook arguments against free-market health care are largely bogus (a vestigial reflection of anti-market bias) and respond by abolishing Medicare and Medicaid, medical licensing, and all the other health care regulations on the books. But Arnold still suggests an interesting hypothetical: What would happen if the typical economist controlled health care policy?
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. Yes, most economists probably favor universal coverage, and I don’t. But few economists want a government monopsony. And they’re on board for three major reforms that I support:
1. Denying care to people on Medicare and Medicaid when their treatment is expensive and the actuarially predicted benefit is small.
2. Substantially raising deductibles for people on Medicare and (maybe) Medicaid.
3. (Moderately) deregulating medical licensing to allow a greater role for doctor’s assistants, nurse practitioners, etc.
In fact, since the typical economist’s argument against means-testing Medicare is that it would undermine its popular support, I think that in this hypothetical scenario that I could convince the typical economist to accept a fourth wise reform:
4. Means-testing Medicare.
So answer me this, Arnold: Isn’t universal coverage bundled together with these four reforms an improvement over the status quo? And isn’t the status quo (or worse) exactly what we’re likely to see as long as the median voter has his way?