The Better Half or the Worse Half?

Arnold Kling, writing about a post of Robin Hanson's, says:

My guess is that if Robin were to try to make this argument to a general audience, he would get a hostile response.

Hanson's argument?

Cutting half of medical spending would seem to cost little in health, and yet would free up vast resources for other health and utility gains. To their shame, health experts have not said this loudly and clearly enough.

...The claim is not that there would be no harmful health effects of such a policy, but rather that harmful effects would be roughly balanced by helpful effects. And the claim is not that harmful and helpful effects would exactly balance, but rather that any net health harm will be small compared to the health gains possible by spending the savings on other health influences, and to the utility gains possible from spending the savings in other ways.

Kling continues:

However, the opposition would be almost entirely emotional, with little or no rational component....The intensity of the emotions is probably a sign that Hanson is onto something.

I don't think it's emotional to ask two questions:

1. Who does the cutting?

2. How does the cutter know, for each affected individual, whether the cut removes the better half or worse half of that individual's health care?

Cato Unbound (where Hanson's post appears) seems to be off-line. Perhaps I'll have more to say when I'm able to read the whole post.

Okay, I've now read Hanson's post. Hanson's point about over-spending on medical care is well supported, but here's the key passage about how to cut spending:

How should we cut medical spending? There are many possibilities, and I may prefer some possibilities to others....The obvious first place to cut would be our government and corporate subsidies for medicine, including direct payments, tax exemptions, and regulatory requirements. Socially, we should also try to give medicine far less prestige than we now do. After these one could consider taxing medicine, limiting it by law, or nationalizing the industry and using agency budgets to limit spending.

Yes, I know, these are not politically realistic proposals.

The least realistic proposals, politically, are to cut government and corporate subsidies, tax exemptions, and regulatory requirements. Such changes would be the most beneficial because they would restore income and discretion to the actual recipients and beneficiaries of medical care.

The politically realistic proposals (taxing medicine, limiting it by law, or nationalizing the industry) would be ruinous. Necessary medical care would become more expensive and harder to come by.

Does Hanson seriously endorse taxes, government-imposed rationing, and nationalization as substitutes for the the judgments of individuals who actually need medical attention? Perhaps he would prefer to live in Canada or the UK.