Megan McArdle takes on the liberal approach and the nanny state in the context of poverty and the SCHIP debate. She makes the point that dignity of the individual requires that people make their own decisions and not allow the government to "improve" them.
The government is really very good at distributing cash, with only the normal deadweight loss attendant on taxation. But it is an abysmal dispenser of advice on how to live your life, which is why the Declaration of Independance promises not happiness, but only the space to pursue same. I'm very open to arguments that private charity can't cover the cash needs of the poor, but I'll pit a private institution against the government in the "better living through social work" game any day of the week, and twice on the last day of the month.
Obviously, I'm against most forms of government help for adults, but is there anything as creepy as the notion that the government is supposed to improve you?
This sounds a lot like the description of medical
paternalism we heard about in ethics class in first year medical school. Of course we don't want other people (physicians or government agencies) making decisions for individuals.
On the other hand, the counter-argument seems embedded in Ms. McArdle's blog's name.
Asymetrical Information is, in this instance, an information deficit, which capital markets assume are part of making the market and thus part of the playing field. If health care is different than other markets (and I don't know that it really is, I will just posit...), then it is here we must look.
A lady in a fur coat passes a homeless man in a sweatshirt on bitter cold New York night, and she is certain he will just spend it on drugs.
If the man has made poor decisions in his life, then he must be held accountable and live or die tonight by his decisions. On the other hand, if he is mentally ill, perhaps a schizophrenic, does have the capacity to make good decisions. Often the delusions and hallucinations that schizophrenics suffer can create the very suspicions that lead them to stop their medications. Can this man be held accountable for his poor decision despite an illness that guarantees his inability to make the decision? Why is this any different than other psychological dynamics that lead to bad decisions?
If this man tends to make bad decisions and he is given money by a government bent on helping people non-paternalistically, will purveyors of health care (or any other product) not swoop in to sell the man things he doesn't need? After all, the markets have their own natural incentives, not the least of which is the single-minded pursuit of capital and profit.
The crux of the matter is that the homeless man generally suffers from a deficit of information (asymmetrical information) and is forced to take someone's advice. So whose advice? Advice from government is probably a little too paternalistic; there are better things to do with my tax money. But what are the alternatives? Advice from the insurance industry? Advice from hospitals, whose financial survival is dependent on selling technology and procedures? At least physicians have the Hippocratic Oath, but this increasingly marginalized when we are encouraged to be entrepreneurial.
Maybe government needs to be part of the solution, but my own principles and ideology would argue that it has be sparingly, carefully and minimally.
This sounds a lot like the description of medical paternalism we heard about in ethics class in first year medical school. Of course we don't want other people (physicians or government agencies) making decisions for individuals.
On the other hand, the counter-argument seems embedded in Ms. McArdle's blog's name. Asymetrical Information is, in this instance, an information deficit, which capital markets assume are part of making the market and thus part of the playing field. If health care is different than other markets (and I don't know that it really is, I will just posit...), then it is here we must look.
A lady in a fur coat passes a homeless man in a sweatshirt on bitter cold New York night, and she is certain he will just spend it on drugs.
If the man has made poor decisions in his life, then he must be held accountable and live or die tonight by his decisions. On the other hand, if he is mentally ill, perhaps a schizophrenic, does have the capacity to make good decisions. Often the delusions and hallucinations that schizophrenics suffer can create the very suspicions that lead them to stop their medications. Can this man be held accountable for his poor decision despite an illness that guarantees his inability to make the decision? Why is this any different than other psychological dynamics that lead to bad decisions?
If this man tends to make bad decisions and he is given money by a government bent on helping people non-paternalistically, will purveyors of health care (or any other product) not swoop in to sell the man things he doesn't need? After all, the markets have their own natural incentives, not the least of which is the single-minded pursuit of capital and profit.
The crux of the matter is that the homeless man generally suffers from a deficit of information (asymmetrical information) and is forced to take someone's advice. So whose advice? Advice from government is probably a little too paternalistic; there are better things to do with my tax money. But what are the alternatives? Advice from the insurance industry? Advice from hospitals, whose financial survival is dependent on selling technology and procedures? At least physicians have the Hippocratic Oath, but this increasingly marginalized when we are encouraged to be entrepreneurial.
Maybe government needs to be part of the solution, but my own principles and ideology would argue that it has be sparingly, carefully and minimally.