If you design a formula to deny granny a pacemaker, knowing that this is the intent of the formula, then you’ve killed granny just as surely as if you’d ordered the doctor to do it directly. That’s the intuition behind the conservative resistance to switching from price rationing to fiat rationing. Using the government’s coercive power to decide the price of something, or who ought to get it, is qualitatively different from the same outcome arising out of voluntary actions in the marketplace. Even if you don’t share the value judgement, it’s not irrational, except in the sense that all human decisions have an element of intuition and emotion baked into them.
Wow. Megan McArdle’s next post on this topic is even better:
I have voiced my various practical objections to the particular options on the table at various moments. But the main thing is that I don’t want to give the government a greater role in health care markets. Nay, not even if all the other countries . . . well, all the cool countries, anyway . . . are doing it. To the liberals proclaiming that, unlike those of us in the conservative or libertarian camps, they are practical people just seeking the best way to make us all better off, I say: I think your utilitarian calculus is badly wrong.
Most definitely, RTWT.