Health care, like all finite commodities, must be rationed. The only real choice involves the mechanism by which that rationing is carried out. It can be based on market forces or it can be based on the whims of some priviledged elite. An article in yesterday’s Telegraph suggests that the former might be more compassionate than the latter:
Smokers, heavy drinkers, the obese and the elderly should be barred from receiving some operations, according to doctors, with most saying the health service cannot afford to provide free care to everyone.
In a survey of 870 family and hospital physicians, a majority said that the NHS should not provide free care to everyone. There was, however, some diversity of opinion concerning which patients should be thrown overboard:
One in three said that elderly patients should not be given free treatment if it were unlikely to do them good for long. Half thought that smokers should be denied a heart bypass, while a quarter believed that the obese should be denied hip replacements.
My bet is that the mothers, wives, and children of these same docs would somehow manage to get special dispensations, regardless of their age or lifestyle choices. It is also probable that people with political or financial pull would somehow be treated.
This is a big problem with government-run health care. Regardless of what you call it, any system that tries to outsmart the market ends up rationing care based on the whims of people who don’t face the consequences of their own decisions.
Is this what we want in our country?