You Still Can't Have It All

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The Bush Administration vetoed the plan. (The Democratic ticket is divided: Clinton supports it, Gore opposes.) Critics call the Oregon scheme "health- care rationing," which is exactly right. But as frustrated defenders of the plan note, we ration care now, except we do it irrationally. We pretend to believe in unlimited health care for all, thereby making it harder to provide decent health care to many. Our refusal to acknowledge that trade-offs are necessary -- including, yes, the ultimate trade-off between money and human life -- makes intelligent debate about intelligent trade-offs impossible.

Not all policy decisions require this kind of trade-off. Economists believe almost unanimously, for example, that free trade between two nations is a win- win situation: both economies benefit. The proposed North American Free Trade Agreement between the U.S., Canada and Mexico thus would cost the U.S. economy nothing on balance, while bringing many benefits.

But NAFTA raises a different kind of trade-off: between economic efficiency and economic fairness. Even if the American economy benefits overall, there will be winners and losers. The obvious solution -- both to grease the political wheels for the agreement and to serve justice -- is for society to compensate the individual losers. For example, there should be generous retraining benefits for those thrown out of work. But conservatives don't like to admit that policies promoting growth can disserve fairness, while liberals don't like to admit that policies promoting fairness can disserve growth. So a natural deal -- pay for fairness policies out of the proceeds of growth policies -- is hard to achieve.

In 1980 M.I.T. economist Lester Thurow published an influential book called The Zero-Sum Society. This became a notorious phrase. Thurow's critics, mostly conservative, accused him of suggesting that the American economy could not change or grow. Thurow's point was, rather, that at any given moment society's resourcesTIME