Over at marginalrevolution.com, Tyler Cowen posted a particularly good entry on famous economists’ famous errors. The average quality of comments on that site is usually higher than on most economics sites, due, in no small part to Tyler’s and Alex’s fairmindedness and perpetual introduction of interesting issues. But this time I thought the average quality of comments was even higher than usual.
I thought I would add a comment on one of the most famous and widely-cited articles on health economics, the 1963 classic by Kenneth Arrow, “Uncertainty and the Welfare Economics of Medical Care.” I seemed to remember a whopper in there about how when you have imperfect information, you necessarily need some kind of government regulation. So I reread the whole article this morning and guess what? I couldn’t find the whopper. Arrow’s article was much more nuanced than I had remembered. So I almost decided not to write this post. But then I thought, “Wait a minute. The main purpose of Econlog is to disseminate good economics. So what if I can’t find errors in Arrow. Isn’t it worthwhile to cite good work also?” I had almost been defeated by selection bias.
His article is well worth reading. In it, you’ll see his proofs that if an insurance company has loading fees (costs besides the payout of benefits), the optimal insurance policy will have a deductible and that if an insurance company is risk averse, it will have some degree of co-insurance in its insurance policies. He also has a beautiful treatment of moral hazard in health insurance, not just in the narrow sense of the incentive not to take care of oneself but also in the wider sense of overspending on medical care.
Arrow also points out that optimality in health insurance requires that higher-risk people be charged higher premiums.
And throughout he writes beautifully.
Arrow also takes seriously Milton Friedman’s proposal, made in his 1962 classic, Capitalism and Freedom, for certification of doctors rather than licensing. Strangely, Arrow doesn’t mention Friedman in this context although he does mention Friedman’s colleague, Reuben Kessel, who also opposed licensing.
READER COMMENTS
Steve Reilly
Jan 4 2009 at 1:24pm
Thanks for the advice on the Arrow article. I just found a copy and I’m ready to dive in. (Also, good to know you liked those MR comments–mine was the early anonymous one that mentioned Ehrlich, Fisher, Samuelson and Black-Sholes.)
Bob Murphy
Jan 5 2009 at 1:38pm
David, good point. “Right wing” economists often sound like the grumpy Muppets in the balcony, so we should try to give praise when appropriate.
Speaking of Arrow, when I was in grad school it struck me that I didn’t need to rely on Austrian “verbal” economics to make most of my points. I could do just about everything in an Arrow-Debreu model. So why is it that we still have all the interventionist policies? They aren’t based on full-blown GE models, they’re instead based on very crude (relatively speaking) New Keynesian stuff.
ryan yin
Jan 5 2009 at 3:46pm
Bob Murphy,
Does much of our (actual) interventionism come out of New Keynesianism? To take the example of health care, how much gov’t spending on health care, direct and indirect, is supported by New Keynesianism, or for that matter by standard redistributionary arguments? It’s not stimulus (since it’s clearly not terribly counter-cyclical) and there’s not much of an insurance argument for most of what we do (in fact, there’s an insurance argument against tax-exempting employer health benefits if you take the redistribution-as-insurance argument seriously, not that anyone really does).
Maybe I just don’t know enough about the theory, but I don’t see how it supports a lot of the policies we actually see.
Comments are closed.