Near the beginning of the health care section of her diavlog with Jon Chait, Megan McArdle correctly observes that no one health care system can serve every person as well as they might be served, and then says “What you’re looking for is the average or the median.” Jon gives this the old “right, right” hoping to move on to more debatable concerns, but I think it is worth saying that a health care system that this is less obviously true than one might think. Simply abolishing Medicaid would, after all, have no real impact on the typical middle-class, middle-aged American and would leave room for him to pay lower taxes. It would just be, you know, wrong.
A lot of the time, I feel like the health care debate gets a little unduly technocratic. It’s unlikely that there’s such a thing as a unique “best” health care system in the sense of “system that works best.” Value issues about allocation of resources to health care versus to other things, and about allocation of health care resources to whom both come into play.