Here’s a comment that I wrote in response to a comment (from “Curtis”) on this post at EconLog by Alberto Mingardi. My vanity demands that I post it also here (with slight amendments) at the Cafe. Specifically, I wrote this comment in response to Curtis’s claim that “The end, affordable healthcare for all, is more important than the means.”
You (like many people) advocate “affordable health care for all.” I’ve a serious question: can you explain what that means? At one extreme, everyone in America can afford Band-Aids; at the other extreme, very few people in America can afford their own private hospital staffed only by Nobel-Prize winners in medicine and the top graduates of Harvard, Johns Hopkins, and Stanford medical schools.
Ability to afford the latter is better – it will render to the person who has it better medical care – than is ability to afford only Band-Aids. But most Americans can afford some level of health-care in between these two extremes. What is the level that you believe should be affordable to all? And what criteria do you use to determine this level?
Three related questions: Suppose that your preferred level is somehow attained:
(1) Is the cost of attaining this level of affordable-to-all health-care relevant? That is, is it possible that, while your preferred level of medical care can be supplied to everyone, what is given up on other fronts as the cost (e.g., less leisure for workers, less-safe automobiles, less-interesting meals at restaurants, smaller-sized homes) is too great to justify the continuing provision of your preferred level of medical care?
(2) Because the likes of Bill Gates and Bill Clinton, being very wealthy, will be able to afford even better medical care than the level that you regard as appropriate for everyone, will you wish to prevent Messrs. Gates, Clinton, and other wealthy Americans from consuming a level of medical care above and beyond your preferred level?
(3) If your answer to the question immediately above is no – that is, if you would not wish to prevent the likes of Gates and Clinton from choosing to spend their money to obtain for themselves and their loved ones levels of medical care superior to that which is “affordable to all” – then not all health care will be affordable to all. Will that reality bother you? Do you think that that reality justifies government intervention?
UPDATE: Here’s a killer comment (to this very Cafe post) by Yevdokiya Zagumenova:
If the ends justify the means then we don’t have a problem. Kill all the poor people and all the sick people. The great thing about the ends justifying the means is that we are no longer constrained by anything as silly as the value of human life.
My guess is that Curtis and many others will dismiss Yevdokiya Zagumenova‘s short comment as irrelevant, as missing the point, or as an inappropriate reductio. But they would be mistaken to do so. Her’s is a deep observation, yet one requiring good practice in the economic way of thinking to appreciate in full.