I don’t know enough about health care to render a definite verdict on future US policy. My baseline preferences were almost identical to what Brad Delong proposes, minus the nanny state vans of medical professionals and not-necessarily-well-supported sin taxes.  This, however, is based solely on my basic intuition about incentives and behavioral economics.  There’s no real nitty gritty analysis behind it.

I am swayed by the fact the people like Ezra Klein, who do know the nitty-gritty, seem to be in favor of a more traditional single-payer program. What doesn’t sit well with me are some the arguments from those who are opposed to single payer.

Everyone seems to accept that the United States has a lower life expectancy than most OECD nations but pays much more, in some cases twice as much, for health care. This is a damning piece of evidence on its face.

The claim by some commentators such Megan McArdle and Greg Mankiw is that this fact should be disregarded because the US does much of the medical innovation and has worse health habits. Yet, the claim that we should disregard this key fact — that we pay much more and our primary outcome indicator is worse — is an extraordinary one.  I have not yet seen extraordinary evidence to support it.

Its not enough to point to some factors which might justify a higher expense for seemingly no gain. You need to show that these factors really do add up to the gap between Europe and the US. Otherwise, the weight of the evidence still falls in favor of those who want a more European style health care system.

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