Of Bananas and Heaven: The Best and the Best

Peter Orszag quoted Uwe Reinhardt, the renowned Princeton economist, who asked: “How can it be that the best medical care in the world costs twice as much as the best medical care in the world?” (see “Helping Orszag Get It Right”)

The answer from Mark Pauly, equally renowned Penn economist, is: “Growing the best bananas is in the world in North Dakota would cost twice as much as growing the best bananas in the world in Puerto Rico (both in the US).  It costs more to raise healthy people in hostile climates, like poverty, social dysfunction, racism and low education.”

And Greg Scanlon, of The Heartland Institute, answered by recalling Jack Wennberg’s observation that women in Lewiston, Maine were much more likely than women in nearby Wiscassett to have a hysterectomy. “Of course, the thing Jack didn’t understand is that Lewiston is heavily French Canadian and Catholic, while Wiscassett is almost entirely Protestant. The ladies of Lewiston were using hysterectomies as a form of birth control that was acceptable to the Church. Researchers often ignore cultural differences when making assessments like these. Is it really so awful that, after having six or eight kids, a woman might want to stop without risking eternal damnation?

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