By Bryan Caplan
I know I had another argument with Bryan this year where I had to
concede to him, but right now I cannot remember the topic. Selective
memory strikes again.
I’m happy to help out. The history of the dispute:
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
2. I replied:
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:
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.
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.
3. Arnold wasn’t entirely convinced, but still concluded:
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.
This was one of the more productive exchanges I had in 2009, and a nice example of why I’m proud to co-blog with the noble Arnold.