Much of what passes for debate over organization and policy these days completely ignores progress. It is, in effect, debate over what to do if nothing ever changed - if all availabilities remained constant, if prices never changed, if new resources were not developed, if existing technologies were not improved. This is completely irrational - everyone knows that this is an age of change and progress - but yet it is commonplace, yet another aspect of the phobia of change that seems hardwired into human nature.
Take this op-ed, for example:
Imagine that someone invented a pill even better than the one I take. Let’s call it the Dorian Gray pill, after the Oscar Wilde character. Every day that you take the Dorian Gray, you will not die, get sick, or even age. Absolutely guaranteed. The catch? A year’s supply costs $150,000. ... Because the price of these new pills well exceeds average income, it would be impossible to provide them for everyone, even if all the economy’s resources were devoted to producing Dorian Gray tablets.
So here is the hard question: How should we, as a society, decide who gets the benefits of this medical breakthrough? Are we going to be health care egalitarians and try to prohibit Bill Gates from using his wealth to outlive Joe Sixpack? Or are we going to learn to live (and die) with vast differences in health outcomes? Is there a middle way?
This is a nonsensical formulation. It's like thinking about how to survive the endless night that will arrive when the sun goes down, ignoring the obvious and long-established fact that the sun will later rise in the morning - it leaves out the most important and time-proven consideration of time and change. When medicines of engineered longevity arrive in reality, the driving question will not be not how to divide the pie there and then, but rather how rapidly competitive research and development will reduce the price and expand the market of people who can afford this new technology.
Every new medical technology was unaffordable and unreliable at first, and then became reliable and affordable. The incentive for any marketplace is to work to make goods simultaneously more reliable and cheap enough to be affordable to new populations of people eager to buy - selling affordable goods to the masses is how to make serious money, not keeping the price high and the market small. This seems to be one of those forms of change that people like to sweep under the rug and ignore, despite the fact that it takes place right now, all around, and in hundreds of different markets.
This dismissal of progress and unwillingness to look beyond what exists right this instant is, I think, a part of human psychology that greatly enables popular support for government regulation - regulation that has the effect of removing incentives for improvement. So instead of a vigorous marketplace in which improvement and falling prices are the order of the day, we wind up with a stultified and overregulated space in which high prices and poor quality dominate because the rewards of innovation have been squashed.