I have a new paper draft ready for wider distribution.  Comments welcome!
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http://hanson.berkeley.edu/showcare.pdf or .ps
                      Showing That You Care: 
                 The Evolution of Health Altruism
                         by Robin Hanson
Altruism, or directly caring about the outcomes of others, is often 
suggested as an important explanation for otherwise puzzling phenomena in 
health policy.  There are many possible ``altruists," however, depending on 
which people and outcomes the altruist cares about.  I propose a specific 
model of health altruism that 1) fits with what we know about our 
ancestors' behavior and environment, and 2) accounts for several health 
policy puzzles.   It assumes that altruism was directed toward social 
allies, that allies prevented health-harming crisis events, and that some 
people knew things that others did not about who would remain an ally.  
This model then offers a simple unified explanation of:
a) regulatory paternalism, especially toward the low status, 
b) value-driven support for national health insurance, 
c) the social-status health-gradient, and 
d) the near-zero marginal health-value of medical care.
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Robin Hanson  
hanson@econ.berkeley.edu     http://hanson.berkeley.edu/   
RWJF Health Policy Scholar             FAX: 510-643-8614 
140 Warren Hall, UC Berkeley, CA 94720-7360 510-643-1884    
after 8/99: Assist. Prof. Economics, George Mason Univ. 
Received on Mon May  3 16:43:53 1999
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