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Monday, June 26, 2017

Let them bring their own cake.

From Marginal Revolution, a meditation on a study showing the US already spends less on health care for the poor than the wealthy:

1. You still might feel we are neglecting the health care of the poor, but I am not sure the majority of the American public would react that way, upon hearing these numbers.  Usually the poor get less of things, as measured by expenditures, even if they might “need” it more.  Health care is an exception to what is otherwise a pretty general rule.  I believe it should be such an exception, but to what degree?  I see a lot of pretty aggressive intuitions out there, mostly without serious justification or without any presentation of what the stopping point should be.

2. Those numbers don’t prove anything, least of all normatively.  Still, they do point my attention in the direction of wondering — yet again — if public health programs are not better than spending more on health care coverage of the poor.  Let’s stop or at least limit poor people from getting sick so many more times.

3. That poor people get sick more times, how much of this is a) poor environment including higher stress and exposure to crime, b) genes, c) inability to afford proper preventive care, d) bad decision-making, including diet, lifestyle, and exercise, and e) sickness causing poverty, and f) other factors.  I know of plenty of individual papers on these topics, but would it go over well to write an “apportionment” paper doling out the relative responsibilities?

4. How much should our decisions on the best health care policy depend on the answer to #3?  How many people are even willing to talk about this right now?

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