Megan (Not McArdle...calm down) writes:
My policy professor taught me that policy beliefs originate from a model of the individual. The rational economic actor is one model of the individual. The policies that you trust are aggregations of your model of the individual:
For health care, my model of the individual:
People live in denial, do not do good risk analysis (as evidenced by my erratic use of bike helmets.) They do not conscientiously save against medical emergencies, even though they could. They do not have the capacity to compare fancy-dancy medical treatments (I should figure out what chemo regimen is best for me? I DO NOT WANT TO, because that is outside my expertise and BORING. I want to trust an expert, if it comes to that.), especially if the pain has already started. They do not have any interest in comparing not-fancy treatments. (When I broke my arm, I realized I had no information whatsoever on which of the four local emergency rooms had good reputations. None. I had never cared until it was too late.) I derive zero utility from comparison shopping for health care; I want someone else to handle it.
I figure people are roughly like me, non-savers, bad risk assessment, more than willing to delegate their health care. (I am not willing to delegate my fitness or nutrition, but that is different from disease or injury.) You know what makes good sense for that model of the individual? Government based health care that does a decent job by me. You know what doesn't make sense? For profit insurance agencies who do not have my best interests at heart.
For what it's worth, this is exactly my model of how individuals relate to health care too. When I bring this up with conservatives, they often protest that individuals simply haven't been properly trained to be mega-rational health care consumers. This sometimes makes me think they've never met any individuals. When i ask what will happen to all those individuals who falter between now and when we've trained people to be perfectly rational, they sort of shrug and say that people have to take responsibility for their own actions.
