Mr. Hoover knows everything. He attended a high-brow graduate school and worked as a Senate aide before becoming a policy expert. (He even pretends to understand Jeremy Bentham.) He is a man who craves acceptance from the other smart people who surround him.
Jim is pretty smart, too, but hasn't squandered his talent working in Washington. Rather than theorizing about economics, Jim takes an authentic risk by starting a business. He ends up employing 20 people and creating the capital that helps pay for their health insurance -- as well as fund many of the social safety net programs that Mr. Hoover dreams up.
These are fictional characters. "Mr. Hoover" represents the self-assured technocrat. "Jim" represents the improvisational enterpreneur. In Bill Easterly's terms, "Mr.Hoover" is a planner and "Jim" is a seeker.
The Obama Administration represents an attempt to elevate the status of planners over that of seekers.
The idea that politics is not about policy, but instead is about the relative status of different groups, was stated by Robin Hanson and Tyler Cowen before I got hold of it. I say this because somehow Recalculation has become "Arnold Kling's idea," even though there are many antecedents and I think of myself as a promoter, not an originator.
Yesterday, I gave two talks at the University of Indiana in Bloomington. In the first talk, I started by referring to the movie Breaking Away, which is set there. Nominally, the movie is about a bicycle race. In fact, it is a movie about a contest for status, between a group of local boys ("cutters") and a group of students. At a national level, the Tea Parties are like the "cutters" and the Democratic elite are like the Indiana students. And the fight over status is as bitter and determined as the bicycle race in the movie.
In health care, I think that a central issue lurking in the background is the status of doctors. In my view, the status of doctors in this country is about as high as it could possibly get. (They think they still have room to gain status, at the expense of insurance companies, but I do not think that will happen.) My guess is that, over the next decade or so, a number of structural factors will cause the status of doctors do decline. Spending growth has to be curtailed. Inefficiencies in health care delivery have to be addressed. I predict that part of the process will be to reduce the authority and autonomy of individual doctors.
For doctors, health care "reform" could be either an opportunity or a threat. It would be a threat if it were used to spur the trend toward diminished physician authority. However, it may represent an opportunity for doctors to use their political clout to slow that trend and to preserve their status. My guess is that in the short run it will be the latter.