Ezra Klein: evaluation

Transcript context

…Even if you cure a lot more cancers, say. If you’re talking about equity, the person who dies at age 46 of cancer — Medicare doesn’t save them. That’s true inequity. We could increase defense spending, which would help much poorer places around the world. It seems the opposite of equity, especially Medicare, to channel so much money to relatively wealthy older people who, for sure, have gotten in 65 years of life. I just don’t buy that you should begin to so radically discount the life and life quality of older people. As you know, people who are older end up at the doctor quite a lot, and putting them back out on the street on that, I don’t think would work. I could come up with versions of this that I think would, in some ways, be a tougher philosophical test. What you just said, what if you begin to cut out half of defense spending, and you move it into public health subsidies for the poor worldwide? Or for that matter, you could do that with Medicare and Medicaid and all of a sudden PEPFAR is covering everything for everybody under the poverty line in the entire world. [sighs] There’s a certain nationalism in this. I do believe you have to take care of your people, but I think that once you have accepted the basic view, as I have, that health insurance is a way that is valuable to take care of people, both in terms of their life outcomes and in terms of the quality of life they lead, then I think you are in a place where zeroing it out for poor and elderly people is a bad idea on the merits and also, obviously, a horrific idea politically. But abundance is not just a relentless expansion of supply. I do want to say that because you can push anything. One of the critiques I’m getting on the left is, funnily, the opposite of the thought experiment you’re offering, which is, “Oh, here come Ezra and Derek saying all that matters is how many solar panels we build, and how many drugs we invent, and how many trains we build. What about the child tax credit? What about childcare for everyone?” The theory here is not meant to replace every other argument in American — or for that matter, global — politics. It doesn’t say you don’t need to think about child tax credits, which I intensely support. It doesn’t mean you don’t have to think about the provision of health insurance. It doesn’t mean you don’t have to think about the provision of public education. There are a certain set of problems that have become very binding on policy things that people who believe what I believe about the world should care about. I’m a Californian. I lived in California for much of the writing of this book. California is a place deranged by supply constraints. The fact that it’s deranged by supply constraints, by the inability to build high-speed rail, by the inability to build homes, by the inability to build clean energy at anything like the pace needed to reach the goals California itself has set for itself should be seen as a real problem. It doesn’t mean it replaces the problem or completely moves it out of anything on the demand side or the subsidy side of the system, but it is a thing that, if you are a liberal, I think, who wants to be honest about the problems of liberal governance, you have to confront. With all the talk of supply constraints, shouldn’t you of all people be obsessed with fertility decline? It makes everything unaffordable. It limits market size.…

Stored transcript either side of the excerpt. The highlighted words are the published quote; the surrounding text is unedited source, never generated.