I haven’t argued in favor of a single-payer healthcare system (or of the awkwardly named Patient Protection and Affordable Care Act*), and I’m not ready to start doing so. But some arguments just aren’t persuasive, like this dreadful analogy from Don Boudreaux:
I have a question for anyone who believes that a single-payer health-care system (where the single payer is government) will reduce the quality-adjusted cost of health-care: will a single-payer pet-food system (where the single-payer for pet food is government) reduce the quality-adjusted cost of pet food? That is, under a single-payer pet-food system (with government as the single payer) will consumers be better supplied, at a lower cost, with pet food than consumers are supplied today with a free market, myriad-payer system for the provision of pet food?
The critical assumption in this argument is that healthcare is the same type of good as pet food. But how defensible is that assumption?
- Does inability to afford pet food negatively affect my ability to afford other goods?
- Does inability to afford pet food potentially cause harm to innocent bystanders?
- Does my ability to afford pet food depend on whether I have pre-existing pets?
- Does feeding my pet involve a risk of unpredictable catastrophic expenses?
I don’t know that the answers to any of those questions would lead to a conclusion that a single-payer healthcare system will reduce its quality-adjusted cost.” I rather doubt they would. But these are relevant questions about market-provided vs. government-provided health care–and obviously quality-adjusted cost is not the sole value by which we should judge the policy–and I’m not sure Boudreaux’s egregiously simplistic analogy is quite so favorable for his side of the argument when those other relevant questions are asked.
* Really, if they’re going to give us a bad law, can’t they at least give us a good acronym?
** Granted, there are positive externalities for the the pet…