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The core argument from economists for things like co-pays and against free healthcare is that absent a cost, people will over-consume health care, which misses

The core argument from economists for things like co-pays and against free healthcare is that absent a cost, people will over-consume health care, which misses the forest for the trees in the same way that the post I was responding does. The notion of humans as primarily rational actors and the conception of policy as needing primarily to guard against exploitation by those actors leads to policies like saying "sorry, as far as the IRS is concerned, those aren't your kids anymore" or "sorry, guess you gotta go without insulin or food," which are frankly fucking monstrous and should be rejected by reasonable people.

dragonwriter 5y ago
> The core argument from economists for things like co-pays and against free healthcare is that absent a cost, people will over-consume health care People dying because they can't afford insulin are usually not dying because they have insurance where the prescription co-pays for insulin is too high, but because they either are actually uninsured, are effectively uninsured because of a high deductible, or have insurance that works on a coinsurance rather than co-payment model. And even then that's usually not really the problem, the problem is usually that they can't afford a more basic life necessity (often food or shelter) for themselves or their dependents, and voluntarily forego (or limit use of) insulin to afford the other need. Which is a real problem (and a real public economic policy problem), but usually not fundamentally a healthcare policy problem. (On the other hand, it's often a problem where moral hazard arguments of the type at issue here contribute to the failure to solve, so the argument about that being the problem may still be correct by a less direct route then seems to have been intended.)
- roughly 5y ago
  I am not arguing about health care policy, I am arguing about the core economic philosophy that makes "just give them the insulin they need so they don't die" not a tractable proposal in our society.

dragonwriter 5y ago

> The core argument from economists for things like co-pays and against free healthcare is that absent a cost, people will over-consume health care People dying because they can't afford insulin are usually not dying because they have insurance where the prescription co-pays for insulin is too high, but because they either are actually uninsured, are effectively uninsured because of a high deductible, or have insurance that works on a coinsurance rather than co-payment model. And even then that's usually not really the problem, the problem is usually that they can't afford a more basic life necessity (often food or shelter) for themselves or their dependents, and voluntarily forego (or limit use of) insulin to afford the other need. Which is a real problem (and a real public economic policy problem), but usually not fundamentally a healthcare policy problem. (On the other hand, it's often a problem where moral hazard arguments of the type at issue here contribute to the failure to solve, so the argument about that being the problem may still be correct by a less direct route then seems to have been intended.)

roughly 5y ago
I am not arguing about health care policy, I am arguing about the core economic philosophy that makes "just give them the insulin they need so they don't die" not a tractable proposal in our society.