All your health is belong to us

By Eric Crampton 02/05/2015


If the one paying the piper calls the tune, be careful who you let pay for dinner.

Britain’s NHS is considering rationing healthcare by a measure of deservingness. Here’s The Guardian:

The NHS plans to dramatically increase rationing of patients’ access to care and treatment in an effort to balance its books, a new survey of health bosses reveals.

Almost two in five of England’s 211 clinical commissioning groups (CCGs) are considering imposing new limits this year on eligibility for services such as IVF, footcare and hip and knee replacements.

Smokers and those who are obese will be among those denied surgery and other treatment, according to a survey of 80 CCG leaders conducted by the Health Service Journal, in an extension of the controversial policy of “lifestyle rationing”.

So. We get tobacco excise taxes to defray the health costs of the public health system. You cannot opt out of the NHS but through the costly route of paying for NHS through your income taxes and excise taxes and then paying separately for private health care. Then smokers could be denied service because of the smoking.

Meanwhile, more paternalism’s being rolled into welfare services. There are pretty reasonable justifications for targeting paternalism towards those who’ve demonstrated a need for extra help in financial planning. Plus, a strongly paternalistic approach could have similar effect to the kind of separating equilibrium that Mill talked about. But it’s still not a nice call. If you’ve been stuck in a crappy school and then disemployed by minimum wages above your marginal product, you then get choice taken away from you on more of the remaining margins.

Now think about Guaranteed Income Proposals. I wonder what private behaviours would become of public regulatory interest when we all reckon not only that the neighbour is doing something we don’t like, but that we’re helping subsidise him to do it.