This kind of moral/political commentary masquerading as economics is a very dangerous thing. Here’s a blog post by James Kwak, part of the Baseline Scenario blog, a cottage industry of quotable commentary on the current economic crisis (he and his colleagues like Simon Johnson are constantly showing up as “expert” interview subjects, mouthing off on whatever twist or turn happens to be in the news that day for admiring reporters).
Mark Thoma links to a medical paper that brings up the issue that few people want to talk about: at what point is the cost of medical care to extend life not justified? Like Thoma, I don’t have a great answer, except to point out that in a world of scarce resources, the answer cannot be that any effort to extend life by any small amount is always a good idea. (And as David Leonhardt explained, our health care system is certainly constrained by scarce resources, whether we like it or not.)
Set aside whether the fault is with this blog post or the sources it links to (it’s both). The problem here is the premise it is implicitly based on — the idea that medical goods and services are different from any other from the consumer’s point of view, or from a moral point of view. How can a “medical paper” opine on whether a health care cost is “justified”? Doesn’t each consumer have his own utility function for that, just as he does for all other goods and services, based on his personal needs, preferences, and endowments? Why is it useful to point to a New York Times’ reporter’s banal observation that these services are scarce resources? What services are not?
These questions only mean anything worth debating if you presume from the start that government is supposed to be paying for these things. That presumption makes these questions a matter of public choice, and this debatable. But if you assume that patients ought to be free to decide as they will, then who cares about any of this?
Framing it this way is not about actually debating the issue of scarce resources at all. For economists like Kwak (aptly named, I might add), the idea is to insert the unspoken premise of government involvement for its own sake — to make a “baseline scenario” of the debate, not to be questioned.