How to Spot Failure

Ezra Klein writes that “libertarianism fails in health care,” by which he means he has identified something he does not like: in a free society, no one would force you to purchase health insurance, whether for yourself or for others, from the government or from private insurers.  Klein doesn’t like that, because of something neither of us likes: it means some irresponsible and/or unfortunate people would end up with expensive medical bills or worse—dead.

But that is like saying, “The Yankees fail because they have a lousy third baseman.”  (Do they? I have no idea.)  It tells us nothing about how well the Yankees perform (how many lives Libertopia would save) on the mound (preventive care), at first base (primary care), in the outfield (acute care and new medical technologies), on double plays (care coordination), or by avoiding unforced errors (same).  It tells us nothing about whether the Yankees’s left fielder plays shallow or the team otherwise adjusts to minimize the lousy-third-baseman problem (whether people would take better care of their health and more people would purchase health insurance), how well the Yankees perform at the plate (generating wealth, improving living standards, and reducing the cost of care to bring it within reach of the poor), or lots of other things that a free economy would do that I could graft onto this lousy simile.

Klein doesn’t even begin to examine how other ways of organizing health care, including our very own health sector, perform on any of these dimensions.  And he certainly doesn’t tell us the score.  All he tells us is what we already knew: that a free market isn’t perfect. Which is to say, he tells us nothing.