Ezra Klein's Confusion Over "Rationing"

Reason ^ | 08/30/2009 | Ronald Bailey

[fiscon1]

Washington Post blogger Ezra Klein is taking exception to Post columnist Charles Krauthammer's depressing op/ed on how health care "reform" will likely play out. Krauthammer's op/ed argues that the public option is dead, as is end of life counseling, and imposing treatment choices through comparative effectiveness studies will be downplayed. The notion that health care reform will cut costs will also be dropped. So what will happen? Krauthammer predicts:

[Gaffer]

Simple fact. If you add 47 MILLION new covered patients to the health environment and don’t add any new doctors or health support personnel, you will have RATIONING.....

[donmeaker]

And why become a doctor or nurse if that is to functionally become a slave.

I don’t understand how they expect anything to become more efficient if price information is withheld, missing or disregarded. I just don’t understand.

[Gaffer]

Here's a good chance to see universal health care in action.

Tune in to the new BBC series "Being Human" It's about Werewolves, Ghosts, and Vampires....okay, it's vampy. However, take a really close look at the venues in which most of the principals in this series work and interact. They're mostly British medical workers. Take a look at their work surroundings, the situations they deal with, the state of their environment....This is what America will get if it enacts Obama's plan.

[bitterohiogunclinger]

“If you add 47 MILLION new covered patients to the health environment.”

Not if they aren't freeloaders. If they were paying their own way, the Doctors and other professionals would increase in number. There would be free market economic incentives to fill the void.

The 47 million number is a smokescreen. Ignore it for a moment. No matter what anyone says or does about how healthcare is paid for, those “uninsured” aren't locked up somewhere not getting healthcare. They already are using the resources. They might not be happy that they don't get what they feel is “owed” them, but they are free to work and pay for any care they want or need.

The true imbalance is created by artificial forces imposed by “The Government” when it regulates and interferes in the process.

[ClearCase_guy]

I think this gets to heart of much disagreement between Leftists and Conservatives.

To the Left, the marketplace is restrictive and oppressive and fundamentally rations all goods and services -- only some folks get expensive homes on the beach. By the same token, if government bureaucrats go into backrooms and write rules and regulations determining who shall have health care and who shall not, well ... I suppose that's rationing too ... but it's not fundamentally different from what we have now, right?

To Conservatives, the marketplace allows people to alter their circumstances. If you work hard enough, you WILL have a house on the beach. Nothing is perfect, but to a large extent, the marketplace will give you what you deserve. Government bureaucrats, however, don't care about individuals, they care about categories. If you are in the wrong category, then you get nothing and there's nothing you can do. Rules are rules.

I suppose it's the difference between the idea of Equal Opportunity and the idea of Equal Outcomes. With equal opportunities, the marketplace will reward those who work hard more than those who are lazy. But with government-mandated Equal Outcomes, we can all be placed in the same, sorry, resource-limited situation. That's the only fair outcome, isn't it? Well, isn't it?

[Habibi]

Hmmm. The scenario, as it's described, would have some problems for the government. As a hypothetical, what would happen if I, as a college student, decided that I would not purchase health insurance? I have never heard of our government forcing us to buy something (in this case, health insurance). Oh, I suppose they could couch it as a tax, or incentivize it like folks with disabilities have to contend with (increase of 10% on premiums for every year you didn't elect medicare coverage when you are on disability even if you have private insurance).

There are various ways to finesse the forced purchase of a product, and call it something else. I see it though, as rather like forcing the purchase of GM products by the populace, which might also result in some interesting town hall meetings. Would you be headed for the pokey if you had the temerity to purchase a Toyota? Inquiring minds want to know. ;-)

[Gaffer]

Yes, we can increase and decrease our supply of healthcare professionals at a moment’s notice...almost instantaneously.......

[Habibi]

“The true imbalance is created by artificial forces imposed by “The Government” when it regulates and interferes in the process.”

And that imbalance is huge already. That’s not to say the the government isn’t attempting to make it “huger”.

[JudgemAll]

It’s the redistribution myth.

On the one hand they promise to take over and give to all.

The catch is that with Cap and Trade, CO2 becomes illegal. So anything goes because the government simply does not have to deliver at all.

Every institution or activity targeted and taken over by Obama is undergoing a national shut down.

It will be the same with health care.

Hyppies who voted for Obambi can say good byes to their nature shops and access to alternatives aside from a sock down their throats.

[KarlInOhio]

One big difference between the free market and government is that if there are multi-month waiting periods during which people are dying from lack of treatment, the free market will be much quicker to respond. Imagine if there were long delays in getting MRIs in a city and compare how long it would take for a hospital to buy a new one (or even run a second shift on their current one) versus running it by the Assistant Undersecretary for Hospital Equipment.

There are some things which government is better at than the free market. The two criteria that are at the top of the list are "is initiation of violence involved" and "are the benefits common to all people as opposed to being individually given". Defense of the nation hits both of those. Medical care hits neither: I can think of few things more individualized than my broken leg.

[bitterohiogunclinger]

I didn't say instantly, and that's a pretty lame issue anyhow.
As I stated, the same number of people needing healthcare exists before and after, no matter what we do or don't do.
The issue is do we insanely decree that everyone is entitled to every procedure and pill and office visit they want for free? If so, then there's nothing to discuss as the system will collapse under it's own weight.
The whole issue boils down to would you work your tail off to put yourself through medical school or about 12 years of study to have the government decide where you work, and how much your allowed to have for your efforts? Or, to put it another way:

The trouble with Capitalism is the unequal distribution of wealth.
The trouble with Communism is the equal distribution of misery.

[Gaffer]

Deep in your own answer to me you validated my argument. It’s not the sudden increase of neverbefore seen ‘new’ patients; it is a neverbeforeseen increase of newly enfranchised medical leeches demanding the type of medical care they could now have that was previously relegated to ‘emergency’ only.

[bitterohiogunclinger]

“it is a neverbeforeseen increase of newly enfranchised medical leeches..”
Absolutely. That plus the “political leeches”.