Would Hayek have favored Obamacare?

In this video Nick Gillespie interviews Erik Angner and Erik is (with qualifications) positively inclined.   A few points:

1. When Hayek wrote, health care costs were quite low as a percentage of gdp.  The same can be said of early Friedman writings (it is startling how little attention Capitalism and Freedom, dating from 1962, pays to “the problems of old people”).  It is not clear how views formed in that era should be extrapolated to the current day.

2. Angner-interpreting-Hayek draws a distinction between mandates — which are allowed — and price controls — which are verboten.  Yet it is hard to have major government involvement in health care without price controls, or should I write “price controls,” in some manner or another.  Third party payments cannot be made at any prices that suppliers might like.  Single payer systems have to bargain over price.  For that matter mandates have to put some limits on what suppliers can charge for the mandated good, including quality limits.  The results may not literally be the same as legally mandated price maximums but a) it is hard for a health care-subsidizing government to avoid interfering with the price mechanism, and b) when viewed in these terms, it is not obvious why interfering with the price mechanism is worse per se than mandates or redistribution.  Mandates and redistribution also interfere with the price mechanism, the former as shown by economic theorems about quantity-price duality and the latter once you think of an income as a price or the result of a set of prices.

3. To make it quite speculative, I believe Hayek — if fast-forwarded into the present — might favor a mix of forced savings into health savings accounts, cash transfers to the poor, and direct government provision of basic health care services for the very needy.  Whether or not I am right, Hayek is far from laissez-faire on health care.  But I doubt Hayek would have come close to supporting ACA.  Most of all, I think he would have been horrified by the lack of legal generality and universality in the different categories of treatment, coverage, prices, subsidies, reimbursement rates, and so on.  I think he would have seen this as a sign of our legal and philosophic barbarism, noting that I am not trying to put the predominance of blame on Obama here.

Here is Eric’s Politico piece on the same topic.


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