Facebook Health Care Status Message Petition
Right now, there is a status message petition cycling around Facebook:
Break down the statement above: "No one should die because they cannot afford health care". Interpreted one way, that's true - no one should die because they can't afford basic preventative care, well established and effective curative medicine, etc. But what about someone who is in a vegetative state that can survive an extra week only if they have a heart and lung transplant that costs a million dollars? Laying aside the scarcity of organs for transplantation, I think we are right, even bound, to say to that person "that million dollars should no be spent to keep you alive - it will keep several other people alive and healthy much more effectively and longer". That person will die sooner if he or she cannot afford to pay for the procedure.
People balk at this as "rationing". They, rightly, wonder who will be making those decisions. But they must be made. We do not have infinite resources, to spend on health care or anything else. In the absence of infinite resources, decisions about where to apply the limited resources we do have must be made somehow. The alternative is to do it the way we do now, based on who has the money to pay, which is determined by a host of factors, none of which bear any relationship to what will deliver the most, best health care to the most people.
I have no patience at all for those who deny reality by arguing that the current system is working or is sustainable. Millions of people have no primary coverage, are incentivized to wait until they are very sick to seek care and then are covered only in extremis in the most expensive, least effective possible way. Costs are determined by two sets of actors: (1) consumers with coverage, who are insulated from the true price of what they are consuming and have no access to good information about comparative quality or effectiveness, and (2) providers who have every incentive to do more and charge more, as that way they make more money and are less exposed to potential liability. Costs thus spiral ever upward, with no mechanism in place to direct the resources where they will do the most good.
I also have no patience for those who deny reality by pretending that our resources are infinite, that we can fix everything by declaring health care to be a human right and that we will somehow be able to provide every possible benefit of care and treatment to everyone.
Either set of false premises will lead to false conclusions. False conclusions will lead to bad decisions. Bad decisions will lead to (more) bad outcomes.
No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day.I went ahead and "signed" this, because it's good as a strong, clear statement of a guiding principle. I have some issues with it as a statement of absolutist philosophy. When ever you get into absolute statements, you get to the question of health care as a human right.
Break down the statement above: "No one should die because they cannot afford health care". Interpreted one way, that's true - no one should die because they can't afford basic preventative care, well established and effective curative medicine, etc. But what about someone who is in a vegetative state that can survive an extra week only if they have a heart and lung transplant that costs a million dollars? Laying aside the scarcity of organs for transplantation, I think we are right, even bound, to say to that person "that million dollars should no be spent to keep you alive - it will keep several other people alive and healthy much more effectively and longer". That person will die sooner if he or she cannot afford to pay for the procedure.
People balk at this as "rationing". They, rightly, wonder who will be making those decisions. But they must be made. We do not have infinite resources, to spend on health care or anything else. In the absence of infinite resources, decisions about where to apply the limited resources we do have must be made somehow. The alternative is to do it the way we do now, based on who has the money to pay, which is determined by a host of factors, none of which bear any relationship to what will deliver the most, best health care to the most people.
I have no patience at all for those who deny reality by arguing that the current system is working or is sustainable. Millions of people have no primary coverage, are incentivized to wait until they are very sick to seek care and then are covered only in extremis in the most expensive, least effective possible way. Costs are determined by two sets of actors: (1) consumers with coverage, who are insulated from the true price of what they are consuming and have no access to good information about comparative quality or effectiveness, and (2) providers who have every incentive to do more and charge more, as that way they make more money and are less exposed to potential liability. Costs thus spiral ever upward, with no mechanism in place to direct the resources where they will do the most good.
I also have no patience for those who deny reality by pretending that our resources are infinite, that we can fix everything by declaring health care to be a human right and that we will somehow be able to provide every possible benefit of care and treatment to everyone.
Either set of false premises will lead to false conclusions. False conclusions will lead to bad decisions. Bad decisions will lead to (more) bad outcomes.
I appreciate your breaking down of two of the biggest cliches out there on health care. I'd also add that health care is already rationed; both by the insurance companies' decisions on what they will and won't cover, and by our culture's decision so far to simply not cover tens of millions of Americans in any reliable way.
ReplyDeleteExactly. Well and crisply said.
ReplyDelete