Monday, August 17, 2009

Editorial At National Review On Rationing

Finally an acknowledgment from the right that medical care resources are scarce and "some constraint has to limit this treatment." While I agree that the "rationing" inherent in price in some markets for goods is an acceptable outcome. I don't believe that this is a method of allocating vital medical resources.

The National Review editorial while announcing that it recognizes the scarcity problem fails to give the thought needed to alleviate the problem of scarcity and how to allocate the resources. Beyond their pronouncement of the free liberalized market they do not offer arguments in which to have a discussion. The free market is less an argument than a philosophical position. At best, I can take from the essay that the markets for flat screen televisions and organs are similar enough that outcomes based purely on individuals price elasticity for medical care is optimal for our society. To put it simple, I think the National Review is saying some people are able to pay and others are not and that is the way it is.

They write:
"The trade-offs should be made, as much as possible, by the people who are most affected by them. Liberalizing health markets, by reducing the obstacles that governments have placed in the way of the development of a large market in individually purchased insurance, is a practical method of facilitating that decentralized choice for all but the most indigent. But nobody should be under any illusions that the trade-offs can be wished away."
It is hard to reconcile their argument that trade offs in care need to be made but should be made by those "who are most affected by them." What does that mean? Who are the people most affected? Is it patients and/or family? Is it doctors? What happens if an indigent person requires an organ transplant at the same time as a person with financial means and insurance? In the liberalized market place is this a "no brainer" question regardless of prognosis, the least price sensitive person gets the organ or will it be more complicated than that? It is inherently more complicated.? I wish the NR addressed this issue as such.

The editorial is incomplete and unclear. But what is clear in their argument I don't like. I'm with David Brooks, I am in favor of "death panels." Sphere: Related Content

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