Get Real Re: Rationing

The Republican fear-mongering about health care “rationing” does not stand up to reasonable scrutiny, such as that provided here by David Leonhardt of the NY Times. All societies must make distributive choices, and it is sheer utopian fantasy to think we could ever provide everyone with all the health care they want, or even need.

Another, related issue that doesn’t get enough attention is that the GOP’s antipathy towards rationing  would seem to protect inefficient, unhelpful health care. You would think “rationing” could only be bad if the item being rationed were, you know, good, but the Republicans don’t even like the idea of assembling data and best-practices information and making them available to doctors. If a certain procedure or treatment works well, it won’t be “rationed” by such harmless regulations. So the Republicans are essentially defending the sacred right of doctors to be wrong.

Another interesting , oft-overlooked irony is the fact that the last time the Republican Party had a health care plan of its own, “rationing” was a quite explicit goal of theirs. What do you think Sen. McCain meant when he talked about consumers taking “individual responsibility,” and becoming “much more responsible in health care costs”? The goal of his health care plan was to force consumers to put more skin in the game by exposing them directly to the costs of health insurance, giving them insufficient funds with which to purchase it, and forcing down insurance costs using the bluntest instrument possible, the consumers’ inability to purchase adequate coverage. You might say the consumer would be doing the rationing rather than the government, but that is not the reality of it: the quality of health insurance would be determined by the seemingly arbitrary amount of the government’s tax credit.

It would be useful to remember such things when dealing with demagogues like Mark Steyn who suggest that President Obama is going to lower costs by euthanizing old people. The claim is not just crass, offensive, and blind to the unavoidable hard choices of policy making, but shockingly lacking in self-awareness to boot.