Why We Have To Ration Healthcare

Posted on May 25, 2007
Filed Under An Introduction to Covert Rationing |

The definition of healthcare rationing

Let’s be clear, first of all, on what we mean by rationing healthcare. Many definitions have been used, and most talk blandly about such things as the allocation of scarce resources, or the fair distribution of available benefits or goods or commodities. DrRich objects to such definitions on the grounds that they are misleadingly soothing. There is nothing pretty about rationing healthcare. Rationing is bad, and if we’ve got to do it we ought to face up to what we’re about. It might keep us more honest. So here’s the definition he likes:

To ration healthcare is to withhold at least some medical services from at least some individuals who would probably benefit from them, because we have decided not to buy those services for everybody who needs them.

 

This definition has the virtue of being straightforward. Also, it puts the onus on us (since we’re the ones deciding not to buy the services) instead of on those nasty “scarce resources” themselves. That makes it more difficult for us to dance around the real issue, which is, if we decide we’ve got no choice but to ration healthcare, then we ought to feel obligated to do it in the least harmful way possible.

Another advantage of this definition is that it gives us a starting point upon which we all can agree: The rationing of healthcare is undesirable, and so it should be undertaken only if there is no other alternative.More...

There is no other alternative.

Unless we’re all willing and able to pay out of our own pockets for all of our own healthcare – a fiscal impossibility – rationing healthcare is an economic imperative. There are two ways of explaining why rationing healthcare is unavoidable, the short way and the long way. Here, we’ll stick to the short explanation. The long explanation (that is, a more fully developed “proof” of the unavoidable necessity of rationing) can be found here.

The short explanation of why we have to ration healthcare:

In any advanced society such as ours, where some sort of centralized funding agency creates a pool of money from which most of the health care bills are paid (whether that centralized funding is accomplished through a government agency like Medicare, or through a private agency like an HMO, or through some combination of these), even if that centralized funding agency is extremely large and powerful and coercive, there still will always be limits to how much money can be placed into the pool. On the other hand, the amount of money that could be conceivably spent to purchase all the potentially useful healthcare for every individual in the population who might benefit from it is essentially limitless. This means that, one way or another, somebody is not going to receive all the available healthcare that might be potentially useful to them. Rationing is occurring. Q.E.D.

DrRich personally finds this explanation to be quite convincing. If you do not, if you buy the story the politicians and the HMOs are selling, that, really, all we have to do is squeeze the inefficiency and the corruption out of the system and no rationing will be needed, you should read this.

Once you accept the inevitability of rationing, you will agree that there are only two ways to do it: openly, or covertly. In his next post DrRich will discuss why we’ve chosen to do it covertly.

Comments

One Response to “Why We Have To Ration Healthcare”

  1. Health Business Blog » Blog Archive » Cost control emergency in Massachusetts on July 26th, 2007 11:45 pm

    [...] there’s a provocative potential answer to all of this over at The Covert Rationing Blog. +del.icio.us +Digg [...]

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