The Covert Rationing Blog

SiCKO and Covert Rationing

August 3rd, 2007 by DrRich

DrRich finally saw Michael Moore’s film SiCKO this week, and found it to be surprisingly affecting. DrRich is quite jaded about the injustices routinely and systematically performed by the American health insurance industry, and has written about them extensively. But even he was moved by the personal stories Moore presented of those who lost their health or their loved ones at the hands of their insurance carriers, and even by the stories of guilt-wracked former insurance company employees who knowingly helped perpetrate these injuries. It is difficult to walk out of this film thinking that the American health insurance industry is anything other than fundamentally evil at its core.

And yet, what might a health insurance executive think upon seeing this film (assuming that any of them could have made it past the first 20 minutes, which is doubtful)? DrRich is of the opinion that true evildoers - folks who delight in knowingly doing what they believe to be inherently harmful acts - are rare. He suspects that that whatever evil persons exist are fairly evenly distributed amongst the professions, and that the insurance industry probably has only a few more than their statistically allotted portion. So how might your average insurance executives react to this movie?

DrRich guesses that such people might feel that Moore has perpetrated an injustice against them. After all, we (i.e., society) have deputized insurance executives to ration our healthcare. Indeed, the US Supreme Court has formally ruled that HMOs were created specifically for this purpose. (See Pegram et al v. Herdrich, 2000.) Yet, we have not allowed them to ration openly, with rules that can be seen and understood by all. (That would be rationing, which is taboo.) So what are the insurance executives to do? Their only option is to ration covertly, and that’s just what they have done. In this light, Moore’s unfriendly exposure of some of the systems they have implemented to conduct this society-mandated, congressionally legislated, Supreme Court approved task of covertly rationing our healthcare might indeed seem somewhat unfair to those executives.

Unfair or not, Moore’s film clearly shows how perverted our current system of healthcare rationing has become. But when you get right down to it, one of the chief perversions is that the money “saved” by instituting the kind of covert rationing Moore illustrates does not end up reducing the cost of healthcare (which is what society wanted when it deputized the insurance industry to ration). Instead, that money winds up as profit.

And this is where DrRich part ways with Moore. Moore’s solution is simply to get rid of the profit motive, to turn the whole thing over to the government. But as the government has already illustrated, it’s brand of covert healthcare rationing is ultimately every bit as draconian and harmful as the covert rationing performed by the insurance industry. Perhaps more so. If we go to universal healthcare with government-controlled covert rationing, Moore’s just going to have to make another movie in a few years to illustrate the new, government-mandated healthcare depredations (assuming that by that time the central authorities will permit him to make such films).

For the ultimate problem is not the profit motive, it’s rationing. There are lots of ways to fund our healthcare system; whether completely through for-profit entities, completely through the government, or through some combination of these. And it’s the funding (and thus the control) mechanism that we always end up fighting over. But no matter what funding mechanism we end up with, and no matter whether we end up there by design or by default, the real question remains: Yes, but how are we going to ration?

Posted in Gekkonian Rationing, Wonkonian Rationing

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