Kristof and the Rule of Two

Nick Kristof presents a case study for the Rule of Two.

Let me offer two counterarguments. 

First, a civilized society compensates for the human propensity to screw up. That’s why we have single-payer firefighters and police officers. . . . Compassion isn’t a sign of weakness, but of civilization. 

My second argument is that if you object to Obamacare because you don’t want to pay Scott’s medical bills, you’re a sucker. You’re already paying those bills. Because Scott wasn’t insured and didn’t get basic preventive care, he accumulated $550,000 in bills [he didn't pay] . .  . We’re all paying for that.

By the rule of two, one of these arguments has to be bullshit. Obviously here it is the second one. Taxpayers and the insured currently pay for a substantial amount of free riding. Kristof would have you believe that under Obamacare, despite substantial expansions of Medicaid and large subsidies for others, we would pay less for other people's healthcare because so much expensive treatment would be avoided when diseases are detected and treated early on. That is mostly bullshit, or at least wishful thinking. There is a substantial costs to screening everyone to detect disease early. In most cases it costs as much or more as waiting and treating the few cases that develop. The CBO estimates for the cost of the Medicare expansion and subsidies is positive to the tune of hundreds of billions over 10 years. If the savings from preventative care were so substantial they should be negative.

Kristof knows this, but at least he is transparent enough to include the real reason he favors increasing health care subsidies and even to put it first.