Man Bites Blog

Matt Yglesias and Ezra Klein have spent most of the day saying that Joe Lieberman’s vow to fillibuster any health care reform bill that includes the Medicare buy-in makes him complicit in the deaths of hundreds of thousands of people.

But just last week, Senate Democrats voted against the Nelson amendment, which would have brought over a critical vote to enact health care reform that would have saved hundreds of thousands of lives. Here’s Yglesias’s blistering reaction:

Nelson’s amendment was bad policy, but with it defeated there aren’t 60 votes for #hcr

Klein had a more philosphical reaction as well.

But wait, if health care reform fails because there Nelson finds the abortion language unacceptable, wouldn’t that make these Democratic Senators complicit in hundreds of thousands of deaths, just like Joe Lieberman would be?

Or do Yglesias and Klein not really believe these numbers themselves, and that while they certainly see passing health care reform as a boon to the common good, taking actions that might prevent it’s passing does not quite make one complicit in thousands of deaths.

Will Wilkinson writes:

That some are able to afford, say, a treatment with very expensive new technology that significantly increases (how much is that?) their chances to survive a devastating cancer compared to the chances of those who cannot afford it does not seem to me unjust, flatly or otherwise. It seems a trivial consequence of the fact that new technology is often much more expensive than older technology

Empahsis mine.

OK — I get that what Will means is that if you have expesnive new technology, it will be distributed somewhat unequally, and that this is not an injustice so much as the intrinsic nature of expensive goods.

Nevertheless, to a person denied treatment, it’s hard to escape the conclusion that WW considers her suffering and perhaps ultimate death as a trivial concern compared to preserving ideological purity of keeping the government out of medicine.

I know that this isn’t how WW feels, and that he beleives that a universal health system will cost more than it saves. The problem is that the people it saves have names and stories that go with them today, whereas the people who might suffer as a result have much less interesting stories.

And thus is the nature of many libertarian arguments, which is why it will be hard for them to gain traction.

There are two distinct but similar arguments that I think are worth teasing apart:

• The Slippery Slope: Once a well-defined principle is set aside in order to permit a controversial policy, there will be no principled grounds to prevent another policy that is deemed unacceptable.
• The Camel’s Nose: If we allow the group proposing the current policy to have a victory in the current debate, it is inevitable that it will pursue and gain other victories that are currently deemed unacceptable.

I thought of this a couple weeks ago reading Stephen Bainbridge writing about health care reform. His argument seemed to boil down to: If we pass modest health care reform, people might like it, and might want more of it. To which I reply: so what? If the modest reforms prove successful, maybe we do need more of it.

For sure, this can be troublesome when the benefits are immediate and the costs are longer term. Witness the mock surprise from cultural liberals that the world has not collapsed after same sex marriage was approved in some states. As if the argument was that there would be an immediate apocalypse if same sex marriage conceded. These same voices would not see St. Louis’s apparent ability to avoid disaster in spite of massive transit cuts as an argument against transit funding. And it is a lot easier to expand programs than to cut them back.

I think it’s also important to note that this is a camel’s nose rather than a slippery slope argument. What cherished principle is being threatened here. Government involvement in health care? With Medicare and Medicaid and Veterans Affairs, and insuring government workers, the government is already immensely engaged in health care.

To me, the “camel’s nose” argument smacks of tribalism. The proposal may not be objectionable, but it’s being proposed by the people with purple hair, and we can’t let them win. As a pro-lifer exasperated with the difficulty of enacting the most modest of protections for the unborn, I am eager to see this type of thinking go away.

Will those favoring the current health care proposals push for more later? I’m quite sure. I’m also quite sure we can say, “no” if we need to.

Continuing the conversation about vacation policy, Tim Lee writes:

No seriously. Recruiting talented employees is difficult, and getting them to be productive is harder. So employers collectively have billions of dollars riding on finding the optimal vacation policy for their firms. The armchair CEOs of the blogosphere, in contrast, just think it would be neat if people got more vacations. Who do you think is more likely to be right?

<snip>

If it were really true that giving employees more vacation days would make them produce more over the course of the year, that would be a double bonus: it would make it easier to recruit employees and it would cause them to produce more stuff. Employers would be stupid not to do it.

First, are we so sure that the market is really such a well-oiled machine that we are confident that vacation policies it has come up with are optimal? Or, like everthing else, is it subject to inertia, an attitude of, “I only had 2 weeks of vacation when I made my way through the ranks, and I worked 80 hour weeks, and doggone it these young whippersnappers can get by with just 2 weeks of vacation as well.” Might there be other factors contributing to these policies besides what is strictly optimal? If so, might it take a little nudge from the government to move them along?

Second, obviously it would be ridiculous to assert that a worker’s absolute productivity would increase with more time off, which is why only Reed and Yglesias’s strawmen made such an argument. Fortunately, that’s not necessary for this to be a good policy.

The assertion is that the marginal productivity of the last week or two of a worker’s time is less than her absolute productivity divided by a week or two.

If that is the case, then in order for employers to gain by offering increased vacation, they would need to lower salaries, but they would not need to lower them by the same percentage as the additional vacation days represent. They would just need to lower them enough to cover the marginal productivity, which is less.

Except for one thing — in order to maintain the same level of productivity, employers would have to hire additional workers. And there are transactional costs to that. In essence, increasing vacation makes sense if

marginal productivity of vacation time <

reduction in salary worker will accept for additional vacation

+ transactional cost to add marginal productivity.

Which is yet another negative impact of linking health care to employment. From an employer’s perspective, it is cheaper to have fewer employees working more hours than to have more employees working fewer hours, because they have to pay for the health care benefits for each additional employee.

Again, the current health care regime proves to be a drag on the economy.