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As I have pointed out before, the monolithic support of “progressives” for socialized medicine has less to do with its economic or medical viability than with their need to feel morally superior to the hoi polloi. However, as Megan McArdle points out, the morality of government-run health care is open to considerable question:
A gigantic single-payer system is a pretty blunt instrument; it transfers money from one group, the young and healthy, to another group, the old and sick … But wholesale transfers to large classes, from large classes, are not good moral philosophy unless those classes are very well specified to the moral effect you are trying to achieve.
She believes that such transfers are justifiable only if the group receiving the wealth is needier and less fortunate than the class from whom the wealth is to be extracted. Moreover, it must be shown that the latter group is somehow responsible for the condition of the former. McArdle thinks single-payer fails to meet any of these criteria.
As a class, are the old and sick needier than the young and healthy? No they are not. They have more assets and less poverty than any other group … As a class, are the old and sick unluckier than the young and healthy? Considering people as beings with duration in both time and space, no they are not … As a class, are the young and healthy more responsible for the bad health of the old and sick? Quite the reverse.
For my part, I prefer to discuss health care reform on the basis of efficiency. The objective data clearly demonstrate that government-run health care is wasteful and does a very poor job of resource allocation. Still, McArdle makes a good case that it is also immoral.
+ May 2007
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