If you design a formula to deny granny a pacemaker, knowing that this is the intent of the formula, then you've killed granny just as surely as if you'd ordered the doctor to do it directly. That's the intuition behind the conservative resistance to switching from price rationing to fiat rationing. Using the government's coercive power to decide the price of something, or who ought to get it, is qualitatively different from the same outcome arising out of voluntary actions in the marketplace. Even if you don't share the value judgement, it's not irrational, except in the sense that all human decisions have an element of intuition and emotion baked into them.I) Sure. "If you design a formula to deny granny a pacemaker, knowing this is the intent of the formula"...and so forth. But is this really the design of the formula, or its intent, from those who are proponents of the public option? Are we seriously to suggest that the idea of providing a government run OPTION - with the intention to rest alongside private market options, with the explicit intent to provide better coverage to folks who don't have or can't seriously count on the private market not to let them fall through the cracks - is intended to deny granny a pacemaker? Is anyone who is making that kind of rebuttal to be taken seriously in the debate?
I don't think that there is "a" regime of social justice to which all right-thinking people subscribe, which [makes] me reluctant to empower technocrats to enforce this mythical consensus.In any case, my only reason for citing her is to point out that, a month after she leapt into the debate, many people on the left still pretend there's no intelligent counterargument on the 'rationing' issue and continue to argue against Sarah Palin's idiotic throwaway line.
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.
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posted by idiopath at 10:22 AM on September 5