My Standard Question for Liberals/Progressives
By Arnold Kling
A commenter suggested to me that Charles Sable does not fit my stereotype of liberals believing that government is the magic solution for human imperfection. But I picked out his paper on health care, and I found exactly that. He says that health care providers need to be able to improve by learning from and correcting mistakes. He then proceeds to offer legislation to force that.
My question for Sable is this:
If you know a better way to run health care organizations, why don’t you start a health care organization?
I would ask this question generically. If a liberal/progressive proposal is supposed to do X, why don’t you start a private entity to do X?
There are examples where this question has a standard answer. For example, “why don’t you start a private entity to discourage the use of carbon fuels?” The answer might be the standard externality argument that the private entity will not be able to overcome individual self-interest, so that government coercion is required.
But in the case of health care quality, I am not sure that there is a reasonable answer. If health care providers are doing a bad job, what stops you from implementing a better model and taking over the market? Are consumers too stupid to know the difference between providers who make lots of unnecessary mistakes and providers who don’t? If they are so stupid as consumers, why do you expect them to be smart as voters?
The way I see it, the main difference between a business entrepreneurship and policy entrepreneurship is that if things do not work out as planned, the policy entrepreneur is insulated from the adverse consequences. For me, that difference does not work in favor policy entrepreneurship.