Much of the debate in health care now dances around the issue of rationing. While this is a valid concern when it comes to a centralized system designed to control bottom line pricing, it is the acme of foolishness to state or even imply that rationing does not exist in the current American system. Of course rationing exists, its just that when it happens without direct mandate its referred to as “the market.”
Whenever scarcity of an item and demand for that item coexist a market is created for that item. Few things in the world do not have scarcity of some degree. The items that don’t have scarcity (or functionly no scarcity) have no market in normal time. Air is plentiful, so no one pays for it. Pure Oxygen is scarcer (it must be harvested) so people actually pay for it. Medical care items (be they objects or services) are scarce (arguably more scarce then need be) and thus a market exists for these items.
A market is rationing. This must be agreed upon before a conversation on why the market form of rationing is superior to centralized rationing.
Glenn Beck in his impassioned remarks on eugenics and his daughters story as referenced by Ganelon is a great starter for the reason why the market is superior to central planning in distributing the scarce resources of health care.
This is a deep arguement that spans generations, so I can not hope to even provide a primer for it here. The question a person supporting a centrally planned system has to ask is this: if someone else decides you don’t deserve treatment, would you still support it?
Willing to sacrifice yourself for the greater good you say? Ok, what about your parents? What about your children? What about that sweet old lady down the street? What about the cute little boy next door?
Is it in anyway justifiable to deny a person the right to attempt to protect themselves? No. Never. It is never proper to deny a person the right to attempt to protect themselves. (I can hear you dissenters now: murders? rapists? really really bad baddies? They have a right to attempt to protect themselves. They don’t have to be successful, but they can certainly make the attempt.) The right to attempt to preserve your life (in its three forms: your possessions, your person, and your freedom) is inalienable. You can no server this right from a human being. No matter who that human being is. This point must be agreed upon before any further discussion of health care can occur.
So once it is agreed that rationing will occur in any system and that a human being can not be denied the attempt at preservation of life, the next question will be raised (quietly at first but louder as scarcity increases) what is a human being?
What is a human being? This question comes in many forms. Are brain dead people no longer human? Are children who have no concept of the future human? Are deformed or diseased people less human? Are some ages of people less valuable as humans? Etc. (And the hotly argued “When does life begin?”/”Is abortion murder?” debate. A debate that Peter Singer answers with 2 years old.)
I myself have posited the question in a different way: does a person who is unproductive (or even negative to production) deserve the same care as a person who is even only minimally productive? The answer to the question as established above is yes, they have the right to attempt to preserve their life. The question has to be asked because of the answer to its companion question that is never asked: does another person have a right to my (or anyone’s) life to preserve (that’s preserve not protect) their own? The answer is of course: No. Never.
Because a person has no right to another persons life, they can not use another persons life to preserve their own.
Something must be traded from one party to the other to compensate for life spent in the service of others.
We must never get the fundamental philosophy of liberty, without it all is lost. You own your life in al of its forms, your possessions (the embodiment of your past), your person (the vessel of your present), and your freedom (the ability to secure your person and possessions in the future). Because you own your life, there are only two ways in which your life can be voluntarily interacted with others: trade and donation. People often donate of themselves, this is the spirit of generosity that keeps the human family connected. People instinctively trade with each other, this is the foundation of all prosperity.
So if medical care (the service or resources used to provide it) is not equally traded for or donated freely it is stolen.
When you steal possessions it is the theft of a persons past. When you steal a persons services it is the enslavement of that persons life.
Think hard about stolen or reproportioned property. Does a stolen or coerced item have the same value as its purchased or donated counterpart? Would health care be any different?
So back to the title question: to ration or not to ration? There is no choice, there must be rationing. The question should be: to steal or not to steal?
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I have formulated a basis for health care reform and I will write about it soon.