Health care rationing that is.
David Leonhardt at the NYT has another Must Read article detailing all of the ways that health care is rationed in the US.
Today, I want to try to explain why the case against rationing isn’t really a substantive argument. It’s a clever set of buzzwords that tries to hide the fact that societies must make choices.
He spends his article taking a look at how rationing is something of an economic fact of life (there aren’t many of us driving one of these) — the allocation of scare resources requires active management, actually making decisions about how those recourses are allocated. Except as far as our medical care is concerned, we don’t actively think about allocating medical resources. So there is a built in passivity (or avoidance behavior of the decisions) that is ratcheting up the cost of our care and ensuring that our outcomes are collectively in the middle of the pack. To that end, they’ve included a very cool graphic:
Ezra Klein also writes about this article and he provides some compelling examples of the premiums we pay for avoiding the rationing decisions:
Want another example? Turn your attention to the dread “waiting lines.” A 2001 survey by the policy journal Health Affairs found that 38 percent of Britons and 27 percent of Canadians reported waiting four months or more for elective surgery. Among Americans, that number was only 5 percent. This, Americans will tell you, is the true measure of our system’s performance. We have our problems. But at least we don’t sit in some European purgatory languishing without our treatments.
There is, however, a flip side to that. The very same survey also looked at cost problems among residents of different countries: 24 percent of Americans reported that they did not get medical care because of cost. Twenty-six percent said they didn’t fill a prescription. And 22 percent said they didn’t get a test or treatment. In Britain and Canada, only about 6 percent of respondents reported that costs had limited their access to care.
The numbers are almost mirror images of each other. Twenty-seven percent of Canadians wait more than four months for treatment, versus only four percent of Americans. Twenty-four percent of Americans can’t afford medical care at all, versus only 6 percent of Canadians.
Much of what you’ll hear as an argument for the upcoming “rationing” of health care pretty much asks you to forget that most of us do not have insurance policies that are not subject to some faceless bureaucrat on the other end of the phone whose concern is not in your health care outcome. And it is clear that the so-called not rationing that we have now, is incredibly expensive for what we get in return.