"Austin Frakt looks at the Republican health legislation, and finds (quoting a report from AcademyHealth) that
[I]t completely eliminates the Agency for Healthcare Research and Quality (Sec. 227), and prohibits any patient-centered outcomes research (Sec. 217) and all economic research within the National Institutes of Health (Page 57, line 19).And remember the hatred aimed at comparative effectiveness research.
So let’s see: the conservative vision is that we can achieve low-cost, quality health care via the magic of the marketplace. This would almost certainly be wrong even under the best conditions. But the actual policy is not just to privatize Medicare and all that, but also to eliminate funding for all research into what actually works.
You sometimes hear conservatives saying that the role of government should be limited to the provision of public goods; obviously I don’t agree. But it turns out that they hate providing public goods, like research, too."
Government conducts and/or funds a lot of research. I should know: they've funded a lot of my research. But apropos to this post, it funds a lot of work in the medical and natural sciences. This wasn't some grand orchestrated outcome. This evolved over time. Government funding of science and precedent for it goes back well into the nineteenth century. Over time private research was folded into public research efforts, or private research efforts were spun off of what was once a public endeavor. After wars we had major discussions about how and whether we should transition frantically constructed wartime research efforts into peacetime endeavors. We've debated how public support for research would relate to research in the universities: both public and private. And we're still debating this, with some people encouraging new systems (see Paula Stephan's How Economics Shapes Science). The current system has evolved from a big froth of decentralized arguments and decisions about the public and private nature of science that have drawn on the tacit, local knowledge of scientists, bureaucrats, investors, teachers, students, and a host of other actors.
That's how the current system spontaneously emerged. Nobody planned what we have.
Now, spontaneous orders change over time, I understand that. There's no obligation for someone who respects spontaneous order to like everything that has evolved.
But just once I'd like to see someone like Don Boudreaux look at the current society we have - the society that has evolved over the years into what we have today - and say something like "you know, if I were a planner I wouldn't have done it this way - I would have proposed X, Y, Z libertarian solution - but spontaneous order is a powerful and robust process and perhaps we should give the social order that we have the benefit of the doubt: it was not planned, it evolved this way for a variety of reasons, and we should be wary of trying to reorder it in a sweeping way".
For some reason there are a lot of adherents of spontaneous order that never seem interested in saying that.