Because most philosophies that frown on reproduction don't survive.

Tuesday, September 08, 2009

Bad Luck vs. Bad Design

In a post on the topic of health care rationing (responding to a progressive post which argued that denying care to people unlikely to see much return was one of the benefits of a centralized health system) Megan McArdle of The Atlantic makes the following observation:
There's another intuition that at least libertarians have, which is that it is not as bad to have undesirable things result from an impersonal process than from an active decision. It is bad if someone's house burns down and they couldn't afford insurance. It's worse if someone's house burns down, and they were in the class of people deemed unworthy by a bureaucrat of having their house rebuilt.

I think almost all progressives have the opposite intuition. They think it's better to try to produce an optimal result, even if that results in individual injustices (which it will--government rules are very broad brush, and will always involve error at the margins). I'm not sure how to bridge that intuitive gap.

It strikes me this is indeed one of the determining differences between those skeptical of and those confident in the ability of a centralized beaurocracy to actually improve the administration of health care (as opposed to its availability, which obviously could be improved simply by throwing enough money around.)

Given the range of viewpoints found around here, I'm curious what others think of this. Is this indeed one of the major dividing lines between progressive and libertarian/conservative viewpoints?


Foxfier said...

It does sound roughly right....

Right- haul yourself up.
Left- the group hauls.

Right- equal opportunity.
Left- equal result.

Right- judge off of what you have done to get where you are.
Left- judge off of where you've come from to get where you are.

Anonymous said...

My take on this is a bit different. I figure, healthcare is already being rationed everywhere in the world, except possibly those idyllic places where everyone is a millionaire and transplant organs are in abundant supply.

For the rest of us, hard decisions have to be made. Death panels must exist. The question is, who will sit on those death panels? Should it be people accountable to stockholders (this is the Republican solution), or should it be people accountable to voters (the Democratic solution)? I want the people on my death panel to be accountable to voters.

Mostly Libertarian Joel

Anonymous said...

You are very naive if you think the bureaucracy is accountable to voters.

Anonymous said...

And another thing: There's always recourse if your insurance company says no. Not so if it's the federal government decreeing it.