The health policy exchange during the Democratic debate on Thursday shows exactly where economics should fit into policy, and politics. I'm not in the business of policy analysis, so instead let's ask how an economist could help Senator Clinton achieve the goal she stated in the debate:
"But if you don't start by saying you're going to achieve universal health care, you will be nibbled to death."
As I said before, I think there are two places for positive economics in the formulation of policy. One is when we ask "what will happen if we do this?", and the second is when we ask the question Hillary's statement invites: "how can I achieve that?". America is no technocracy, so there's no way positive economics can tell us what to do; that question is for every person and every candidate to decide.
This doesn't just apply to questions within the rules of the game. If we take the biggest possible economic question, "how should our resources be allocated?", it's still the case that positive economic science cannot tell us, for example, which of capitalist markets, socialist planning, or making decisions by rolling dice is "best". It's not even difficult - it's impossible. The furthest positive economics can go is to say that if you want to achieve some particular objective then one of the systems might be the most successful, but that obviously relies on the purely subjective notion of what you want.
Even when our questions get more specific - for example, not "how should our resources be allocated?" but "what should we do about health care?" - exactly the same principle applies. So, with that in mind, Senator Clinton has taken the subjective position in support of "universal health care". Let's take a look at the second part of the quotation from the debate:
"But if you don't start by saying you're going to achieve universal health care, you will be nibbled to death."
The argument there is that if you don't define your normative goal well enough, even getting close to it becomes more difficult, which is probably true. Even more fundamentally, it's impossible for a politician to be "wrong" when taking a normative position. Like I said, I won't try a policy analysis asking whether Clinton's policies will really achieve her goal, and I make no judgment on that question.
With that in mind: unfortunately, actual policy has to be made to try to achieve the normative goal. If there's significant doubt that the policy will lead to the outcome stated in the goal, then the politician is misguided or, worse, lying. Political campaigns sometimes seem to promote either depressive pronouncements of how we're all going down in flames, or their ideological counterpart, the Utopian "I can make it all better", neither of which have much in common with the real goals of the candidate. Realism doesn't often sell well, but noble aims without realism run dangerously close to fraud.
To put this in a real context, even if I don't care about your immigration policy, I care about whether or not you are honest in presenting it. Again, positive economics can't say whether you should close the borders; it can (perhaps) describe some of the likely consequences of doing so, and to convince me that your plan to close the borders is sensible you must convince me that, on balance, the many dimensions (moral, financial, political) of the problem favor your plan. If, in doing so, you fail to acknowledge or deny the consequences your argument is immediately bankrupt. That doesn't only apply to whatever consequences economic science can help us figure out - it applies to everything.
Even though I believe that economics can be a tool for analyzing more than just financial consequences, it would be wrong to claim that economic science can tell us everything we need to do. If it could, we might as well just cede to a technocracy. What we can do is help set out the means to your chosen end (as in the example of achieving universal health care), or describe the consequences of your policy (as in the example of closing the borders). To argue that other things matter more than what economic science tells us is defensible; to lie about what economic science tells us is wrong.
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