The murmur of the snarkmatrix…

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The untenable zero

Via Andrew Sullivan comes Atlantic colleague Max Fischer, “A Free-Market Case for the Public Option.” I’ll just pull the same graf as Sullivan:

Something like televisions exist in a free market because consumers, if they don’t like any of the new TVs on the market, can simply keep their old one. If they really don’t like the market, they can even forgo owning one altogether; it will make you unpopular on game day, but it won’t risk your life. Insurance is different. Anyone with a sense of basic self-preservation has no choice but to buy health insurance every single month. You cannot opt out, there are few options to choose from, and it’s difficult to know how to price your future risk of injury. So health insurance companies have distorted incentives to innovate or provide a more cost-effective product.

With ordinary goods, the zero-position ownership is acceptable and even virtuous. Not so with health care.

There are a few goods that are similar, like education. You could, under a highly charged set of circumstances, opt out of giving yourself or your child a basic education, and there are many parts of the world where this is not uncommon. Nobody, however, really seems to think that this is a good thing — whether you’re home-schooling, using private education, or sending your kid to a public school, the norm is that your kids ought to get an education. And in industrialized democracies, there’s usually a robust system of public education which (problems and inequalities aside) does a good job of serving most people’s basic needs.

The question is whether the zero-position of health care is something like “ambulance in the event of a gunshot wound” or something more like K-12 education. (I think our views on the zero-position of education are changing too, as access to good pre-K and postsecondary ed look more like defaults rather than extras.)


The comments at that section are deeply depressing, and there is only the faintest recognition that in health-care, like education, the purchaser has an obligation to society not to “opt out” because opting out causes ripple effects beyond their control.

The snarkmatrix awaits you

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