Her argument, in a nutshell, is, "Either you agree that poor kids should be allowed to exit until the system works for them, or they don't." What? Since when do libertarians think making something cost money is the same as prohibiting you to do it? Poor kids can exit the system. They just need to become rich kids. But does Megan apply this theory widely? Does she agree that the Federal Government should pay for all Americans to have health insurance from any insurer, either public or private, that they want, at least until Aetna begins working better? Because if she does, then I've massively misunderstood her writing up till this point. If she doesn't, however, then her constant screech of hypocrite throughout this argument makes no sense -- particularly given that she has awesome, employer-funded insurance, while all millions of Americans are trapped on the individual market.
But this . . . makes no sense.
We force kids to go to school. We are literally keeping them from exiting the system: between the ages of six and 16, they have to be there eight hours a day. Affluent parents get to choose which system they participate in; poor parents don't. I think poor kids also have a right to exit the schools if they aren't--as they are not--getting a decent education.
The critique also fails because the fact that I think (as I do) that the government should buy education for those who cannot does not mean that I think it should buy every other good out there. There are many goods that poor people can't afford to buy. Some of them we think of as basic goods that everyone should have the opportunity to secure for themselves, like food and housing. Some of them are not basic goods that everyone should have the opportunity to buy, like BMWs. As a society, we've decided that education is one of those goods, and I wholeheartedly agree. That's why, when the government system doesn't work, I think it has an obligation to provide those without means a way to exit the system, just as when the local county mental hospital has a fire, the government has an absolute moral obligation to put the patients somewhere else rather than forcing them to squat in the ruins because they're planning a big new building that will be available no later than 2031.
But that doesn't mean I think the government needs to allow us to exit from every system that is less than ideal. I can only buy pants at about four stores in America, and that's a damn shame, but it doesn't cry out to heaven for (government imposed) justice. The fact that Ezra believes that universal health insurance is also a good the government should supply does not impose on me the need to agree with him--and indeed, as I've said at unfortunate length, I don't. The "gotcha" only works if I really, secretly, in my heart of hearts, think healthcare is in the same class of goods as education. The notion that deep down, libertarians really know that liberals are right is widespread, but guys, I swear: honest, way down deep, in the uttermost depths of our souls, we really do think your ideas about domestic social programs are dead wrong.
What's even weirder--and Ezra is not the first person to bring this up--is that Medicaid works on my model, not theirs. Medicaid recipients meet the income barrier, and then they go to any doctor who will take their Medicaid card. No one forces them to go to the nearest doctor, or asks them to apply to the doctor lottery. That's what the NHS does, and almost everyone in the liberal health care policy establishment, including, IIRC, Ezra, agrees that it is a really bad system for providing health care. At least, I think that's what they believe, because every time the NHS comes up, they rush to assure me that when we have national health insurance, it won't be some crappy, government-run system like the NHS; it'll be like France where you get to (wait for it) choose your doctor and have the government pay. It's almost like the government was giving you a voucher or something.
What I want to know from Ezra, and other liberal policy wonks who support a France-type system is: why is education special? I have a model for what goods the government should buy versus what goods the government should actually provide directly; it has to do with geography, non-excludability, and transaction costs. But what is your model for saying that education is in a special class of goods that are rival and excludable, have ordinary levels of transaction costs, and yet nonetheless need to be provided directly by the government? Any of the problems that distinguish education from other goods, like inelastic demand, information asymmetries, and performance measurement difficulties, apply to health care as well, perhaps more so. So why do you want healthcare by la Sécurité sociale, but education by the NHS?
This article available online at: