Noah Smith wants to believe that academic economists are more sophisticated that many suppose. He makes this point by showing how silly it was for an economist from the University of Chicago to ask David Cameron how purchasing healthcare was any different from purchasing a car. David Cameron ended his audience with the professor without debating that point with the professor. He knows that National Healthcare in the UK is not the same as purchasing a car. Smith concludes that most economists would agree with David Cameron. They are not married to the concept of completely free markets.
Smith makes a good point. Most economists are more sophisticated than many imagine. However, the favored conservative approach to healthcare reform is consumer directed healthcare. They would like the healthcare market to be more like the market for purchasing a car. They realize that healthcare is expensive, and that many could not afford adequate healthcare without government support. On the other hand, they would like to limit the expense of subsidizing healthcare. They hope to accomplish this by providing vouchers that could be used to purchase healthcare. The value of the the vouchers would not increase over time at the rate of healthcare price inflation. Consequently, consumers would have to ration their purchase of healthcare services. The price system is a rationing system. We don't purchase luxury cars because we can't pay the market price. Similarly, the value of the vouchers provided by government would determine whether healthcare consumers could purchase the best available healthcare services.