James Buchanan as a Health Economist

Abstract

The broad and deep themes of the role of the individual relative to the state, and the proper long-term rules for the conduct of society were James Buchanan’s primary areas of interest. He did not write much on the popular events of the day (with the notable exception of Academia in Anarchy); he is not a “policy analyst” although he certainly has provided one of the definitive models for the analysis of collective policy. However, one other area of application which did tempt his interest—with that interest responsible for much of the direction of my own career—was medical care. He was the sole author on two essays on medical care, and co-authored a third (with C.M. Lindsay, The Organization and Financing of Medical Care in the United States.) In this note I want to comment on the ideas expressed in the two singly-authored essays, placing them in the context of the large and growing body of research on medical economics, while at the same time spotlighting some insights so far neglected which could be discovered with profit by medical economists, and perhaps by the economics profession as a while. Along the way I will mention the tension that any economist of a reflective nature, of which James Buchanan was the example par excellence, feels which confronting an applied and politically charged issue.