McArdle on the morality of healthcare finance
Speaking of Megan, I’ll point readers to a long and rambling post by this (usually) very excellent blogger on healthcare — a subject near and dear to all the wonkishly minded these days. It’s frankly a bit sprawling and unfocused, so I’ll just cut to the chase — namely, my reaction. And my reaction is that trying to look at the particulars of health care finance as a moral issue is tiresome in the extreme.
There’s nothing more important than considerations of moral philosophy, but something as dry and policy wonkish as health insurance should be reserved for the utilitarians.
In my view making sure everybody has robust insurance coverage via the use of taxpayer money just makes sense. It’s not necessary to talk about justice.
If the US were to enact guaranteed, universal health insurance — adapting the best practices in place throughout the rich world for use in America — the country’s wealthy would hardly be worse off, even if their taxes were to increase. If you don’t believe this, ask rich folks in Australia or Denmark whether or not they enjoy high standards of living. The wealthy can afford to pay more in taxes. When you’ve got a lot of money you can afford things.
Middle and upper middle class people don’t have much room in the family budget for higher taxes, but theirs wouldn’t have to increase very much – and in amny cases they’d come out ahead (I guarantee you some poor schmuck paying 1,400 bucks a month for COBRA coverage would be better off financially were he to pocket the premium and pay Ontario levels of taxation). And the freedom — yes, let’s call it by it’s real name — the freedom to never have to worry about losing your coverage; the freedom from job lock; the freedom to join an exciting but risky start up; the freedom from the threat of disease-induced penury; the freedom of knowing your children’s health insurance can never be canceled — the value of such freedoms would be priceless to average people.
And, the poor, of course, would come out ahead with a robust system of universal health insurance — no calculus required.
Oh, and lots of businesses would realize a net advantage, as well.
Let’s keep it simple. Leave the discussions about angels and pinheads for the philosophers. The rest of us can debate and discuss costs and benefits.