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The Health Care System
- Explained at Last!
The Rationing Imperative Health care economists have accepted as an axiom that we must ration our health care, and indeed we are already doing so. We have reviewed the reasoning behind this rationing imperative elsewhere, and will not belabor the point here. The notion that we're rationing our health care is not nearly as radical as it was just two or three years ago. In fact, on June 12, 2000 the U.S. Supreme Court essentially declared rationing to be our official health care policy. On that date the court opined that Ms. Cynthia Herdrich could not collect damages from her HMO specifically because the job of HMOs is to ration our health care. Therefore, it's not fair to hold them liable when they find creative ways of doing so. (Click here for a commentary on the Herdrich case.) So, while the notion of rationing is no longer anathema, what is still not generally appreciated are the implications of our need to ration health care. |
First, let's consider the definition of health care rationing: To ration health care is to withhold at least some useful health care from at least some people who are likely to benefit from that care. What this means is that, by definition, people are going to be harmed by rationing health care. While we may have the opportunity to choose who gets harmed and how much harm they experience, there's no avoiding the harm.
Second, rationing health care means just that. Beneficial care, not waste or fraud or inefficiency, will have to be eliminated. We're going to have to cut out some of the good stuff. (After all, if there were enough waste or fraud in the system such that eliminating it would be all we'd need to do, then rationing wouldn't be necessaary. We fully realize that, for public consumption at least, U.S. health care policy is based on the premise that we will avoid rationing by eliminating waste, fraud and inefficiency. But this premise is a manifest fiction, and is now is certified as such by the U.S. Supreme Court. Again, we have laid out the proof of this assertion - that there's not enough waste in the system to avoid the need to ration - elsewhere.)
Third, the fact that rationing care is an economic imperative means that we will ration our health care, and indeed are already doing so, whether we agree to or not, whether we choose to do it fairly or not, or whether we recognize our rationing activity for what it is, or not.
The real choice we have to make, then, is not whether to ration health care, but how to do it. Should we try to find a way to ration fairly, or should we look the other way and "let nature take its course?"
Next - The American health care myth
Surviving the Health Care System is adapted with permission from YourDoctorintheFamily.com
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