In any kind of national health system, some treatments will, by simple cost-benefit calculation, be deemed too expensive to provide to all citizens. But does that mean those of above-average income should be excluded as well? Should they lose basic benefits if they choose to pay for these marginal services with their own money?UPDATE: Steven Levitt nails education (hint, it's not about the kids):
If you say yes to this last question, as the U.K. health service has, here is a related one: Should a parent who hires an after-school tutor for his child be barred from sending the child to the public schools?
Some people like to think of health care and education of basic human rights. Maybe they are. But they are also normal goods. That is, the income elasticity of demand is positive. It is hard to escape the conclusion that the right cost-benefit calculation for providing the good depends on the income of the consumer.
Achieving both efficiency and equality in the provision of these goods is impossible. Dealing with this conflict will provide a major challenge to the political system in the years to come.
A non-academic friend and I once had the idea of taking my cheating detection tools and turning them into a business to help school districts across the country. It turns out, however, that school districts don’t really want to catch cheaters. Cheating detection makes the districts’ test scores go down, and leads to problems with teachers’ unions. As such, no one wanted to buy our services.