I realize I forgot to provide a link to the long-ago debate between me and Adam Gopnik on the Canadian health care system. Here it is.
Why have I changed my mind? Some of my reasons are in the piece on moral hazard I wrote for the New Yorker last summer.
The bigger reason is simply that I woke up one day and realized what much smarter people than me (Adam Gopnik) realized a long time ago, which is that the idea of employer-based health care is just plain stupid—and only our familiarity with it and sheer inertia prevent us from rising up in rebellion. I always try to think of a suitable analogy and fail. The closest I can come is to imagine if we had employer-based subways in New York. You could ride the subway if you had a job. But if you lost your job, you would either have to walk or pay a prohibitively expensive subway surcharge. Of course, if you lost your job you would need the subway more than ever, because you couldn't afford taxis and you would need to travel around looking for work. Right? In any case, what logical connection is there between employment and transporation? If you can answer that question, you can solve the riddle of the U.S. health care system. And maybe I'll change my mind back.