Tied to the mast
…but orange now and black

It is well that blog war is so terrible…

…else we would grow too fond of it.

For the sole purpose of making Tom feel guilty, I’m not even going to make him wait a day, or even 6 hours for my response to his most recent blog war offensive. As I read it, I think that we’ve pretty much gotten each other on the same page with Palin and Paglia and so I won’t subject you (my dear reader) to any more of them in the proceeding post.

But jumping right in on the Krugman thing: You (Tom) are probably right about him deliberately ignoring Chicago school health-econ for his assessing it to be unserious and not worth responding to. That said, since it is taken so seriously in the broader discourse—even following what should have been its systematic delegitim[ization] in the face of the events of the last year—why not swat that shit down explicitly?

I also still think that he under-justifies why improving health care via increasing the public presence is a better option than improving health care through a free market approach, which to me is what he was papering over by talking sweepingly about “all health economists,” and which to me would represent the most tenable alternative solution from a conservative perspective. Such a conservative perspective is one that most “Conservatives” don’t pursue with any seriousness for being too deep in the pockets of the insurance industry… here’s hoping that a few more years (decades) out of power and maybe they’ll start sucking less in that regard.

The system currently in place is far from the kind of free market that maximizes efficiency… there are all kinds of information imbalances, monopolies, collusions, etc. that put consumers at a massive disadvantage relative to insurance and other health services providers. This is my issues with Posner’s graf that we’ve been discussing: his base assumption is that the American system currently in place is an approximation of a competitive market (a necessary assumption if his graphs and models are to obtain). As such he doesn’t even suggest as a possibility putting regulations in place designed to increase supplier competition, increasing consumer choice / access to information about services, blah blah yabber.

I prefer the public route because I’m skeptical of the market’s ability to commodify health without massively distorting it from the ‘consumer’ perspective. People can’t think on the margin when they’re buying health-services. Health is too immediate. Also, health is so personal—it’s not like people conspicuously consume the type of health care that is at issue in this debate. As such it’s very difficult to get a sense of generalized value. And even if people did go around bragging about how many colonoscopies they’ve had in the last year, the subjective “use” value—if you could quantify that—of a colonoscopy (or an emergency room visit) to each patient, I would say, varies much more widely than the use value of, say, a barbie to each parent who buys one for his or her kid.

It’s things like this that are at the root of why, as you point out,  the “compensation for doctors is in no way correlated with health outcomes.”Ultimately I think that it’s reasons like these that are at the root of why in general the American system has gotten so convoluted. Public prioritization and resource allocations has its problems, but its at least able to be coherent (whereas, as I’ve been trying to get across, I have serious doubts about even the possibility of the market in this instance being so able). That fact alone suggests to me that it can be considerably more efficient from the vantage point of improving health-economic outcomes (though obviously not from the vantage point of making Tom Daschle, among others, a rich bitch).

This, though, is straight up a Marxist analysis (oh shit!), so, to loop back, I understand perfectly well why Krugman doesn’t go this route explicitly. I just think that it’s lame and, though savvy, tinged with its own kind of intellectual dishonesty if this is indeed where he’s coming from. That said, I suppose honesty in that respect could doom the effort in the really critical short run, so… I guess I don’t begrudge Krugman for playing rhetorical games, but since my original argument (if I remember) was something along the lines of that all public intellectuals play rhetorical games, I’m going to pretend that I just proved that you’re both wrong and stupid. Booya.


2 Responses to “It is well that blog war is so terrible…”

  1. Aww fucking snap. Look. It’s 19 thousand degrees outside. I’m going to kick your blogwarring ass tomorrow though. You done been warned, playa.

  2. […] apparently had nothing better to do this afternoon, and so he responded to my earlier continuation of the blogwar.  Fortunately, my girlfriend and […]

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