Greg Mankiw has already linked to Princeton economist Uwe Reinhardt’s thoughtful discussion of the economist’s concept of efficiency, so this post may not be necessary. I would add that Professor Reinhardt writes clearly, without jargon. You do not need a degree in economics to understand his message. And do not miss his assignment for students. Here is a brief excerpt from that assignment:
Different people can differ honorably on the ethical precepts that should be imposed upon the distribution of health care in a nation. To illustrate, in an article published in the Journal of the American Medical Association (JAMA) of November 5, 1997, I had raised in passing the following question:
“As a matter of national policy, and to the extent that a health system can make it possible, should the child of a poor American family have the same chance of avoiding preventable illness or of being cured from a given illness as does the child of a rich American family?”
Of the several readers who responded to that question, only one, Richard A. Epstein, LLB, Distinguished Professor of Law of the University of Chicago, answered it forthrightly. He wrote:
“The correct answer is no. … His proposal for equal medical treatment perversely requires more care to children of poor parents than to children of rich ones, precisely because the rich families can more easily avoid injury or illness and can better pick up any slack in health care delivery. Worse, programmatic success depends not just on offering carrots but wielding sticks in overriding parental judgments on children’s food, lifestyle and education.” (JAMA, vol. 279, No. 10, March 11, 1998.; p. 745.)
I do not share Professor Epstein’s view on children in society. Indeed, I had answered my own question in this commentary in the affirmative, on the assumption that we in America aspire to an “equal opportunity” society. Good health is part of that opportunity. But I respect Professor Epstein immensely for having had the courtesy and courage to answer my question so forthrightly.
Uwe E. Reinhardt, HOMEWORK ASSIGNMENT NO. 4, ECON 100/FALL 2005.
Reinhardt’s blog post is “When Value Judgments Masquerade as Science”, Economix, 27 August 2010, where there is a link to this assignment.
