>
Whatever you think about US health care and drug prices, we should not rely on a system that requires individual actors to be good people. We should strive for a system that does not require moral actors to function.I don't think it's desirable or even possible, and even if, it would be prohibitively expensive. Ultimately, the society itself is held together by trust and assumption that people generally behave morally. In every area where this assumption doesn't hold we have to enact laws and systems that counter bad behaviour, and those are usually very costly and slow things down (just think about airport security). Trust is what allows us create efficient systems that save money by not having to strongarm people into particular patterns of behaviour, assuming instead they'll follow those patterns of their own accord.
Moreover, systems disconnected from human morality seem to be an ultimate case of following the letter instead of spirit of the law. It risks turning a system into self-perpetuating one that doesn't care about its intended purpose. If everything in healthcare would follow just the letter, how would we make sure it serves its actual function, i.e. keeping people healthy and happy?
Lastly, I believe that codifying things is a tradeoff with a serious cost - written laws have much smaller expressive power than intent-based rules. The world is complicated, people are complicated, but we all share the same brain architecture that does most of the work for us. To codify a simple "be good to each other" rule, you have to write and maintain thousands and thousands of pages of legalese, ridden with contradictions and corner cases. That's a huge cost.
I'm not saying we shouldn't write laws, or design systems to minimmize individual impact. But we need to remember that it's a trade-off. It's like the main problem of programming: computers are dumb, they don't know what we mean. The laws don't know it either (they're basically code). But we do. We have a tremendous advantage built right in. We shouldn't be so quick to reject it because we're afraid of others.