Friday, January 07, 2011

Health Care as "Fixing Broken Windows"

 I'm reading with interest the reports on a new paper by David M. Cutler that repealing Obamacare would cost 250,000 to 400,000 jobs annually over the next ten years.  I'm not the one to evaluate the accuracy of the estimate although I accept the narrow premise that losing all those jobs would be a Bad Thing.  Still, shouldn't we feel a bit dicey about an economy that depends so much on our common infirmity and malaise?  Wasn't it Lester Thurow who said that we can't all get rich taking out each others' appendix?*

Don't misunderstand, I take second place to no one in my affection for my doctor: were it not for the great good fortune of reasonably good health, I'd want to have her on my speed dial.  And there are plenty of health misfortunes (like, I suppose appendicitis) that just happen.  But it's surely true that a lot of our health-care costs are the result of rotten lifestyle choices--obesity, smoking, whatever (well--obesity and smoking cover a lot).  Fixing the damage of obesity and smoking is a lot like fixing those broken windows that should never have broken in the first place, as in Bastiat's great fable.

[Aside from "unavoidable" costs, other reason's why I'm wrong: some portion of health care spending (and employment) is "prevention"--trying to keep those windows from being broken in the first place; and some is "research:--trying to make the health care pie higher, as they say.  Still...]

*Thurow: I was going to ask--"whatever happened to that guy, anyway?  Turns out he is still going strong.   But in a winner-take-all society, if you're not Paul Krugman, I guess you're not much.

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