The New York Times had an article today about the claim that socialized medicine* will lead to health care rationing. According to the writer, rationing is “an inescapable part of economic life.”
It is the process of allocating scarce resources. Even in the United States, the richest society in human history, we are constantly rationing. We ration spots in good public high schools. We ration lakefront homes. We ration the best cuts of steak and wild-caught salmon.
Missing from this explanation of rationing is any acknowledgement, let alone definition, of the difference between a free market and a centrally planned economy. Rationing of spots in public high schools, done by government force, is equated with the free market’s rationing of lakefront homes and the best cuts of steak. The writer began the article by saying that:
Access to medical care is a fundamental right.
Certainly, man has the right to the pursuit of medical care. But there is no right to be given medical care by anyone. Just as the government shouldn’t be involved in rationing property, so it shouldn’t be involved in rationing medical care. To do so implies ownership of the property, in the first case, and of the doctors, nurses, and other health care professionals, in the second.
Health care, I realize, seems as if it should be different. But it isn’t. Already, we cannot afford every form of medical care that we might like. So we ration.
We spend billions of dollars on operations, tests and drugs that haven’t been proved to make people healthier. Yet we have not spent the money to install computerized medical records — and we suffer more medical errors than many other countries.
Here the writer describes individuals deciding for themselves how to spend their money on health care. This, he points out, is rationing. It’s already being done. So what’s the big deal? For him, the only difference between this rationing, and the rationing of socialized medicine, is that the government bureaucrats will do a better job of rationing than individuals will do for themselves.
The difference, of course, is that one is done under the system of freedom, in which a man’s rights are inalienable, and the other under the compulsion of the state, in which man’s rights are abrogated. That’s the difference between day and night, and yet the writer sees, or pretends to see, no political or ethical difference at all. He simply believes one system is more efficient than the other:
Milton Friedman’s beloved line is a good way to frame the issue: There is no such thing as a free lunch. The choice isn’t between rationing and not rationing. It’s between rationing well and rationing badly. Given that the United States devotes far more of its economy to health care than other rich countries, and gets worse results by many measures, it’s hard to argue that we are now rationing very rationally.
Finally, the writer suggests opposition to socialized medicine is a “utopian stand”:
But flat-out opposition to comparative effectiveness is, in the end, opposition to making good choices. And all the noise about rationing is not really a courageous stand against less medical care. It’s a utopian stand against better medical care.
It’s hard to say what he means by “utopian.” Perhaps this is his oblique way of referring to that old fashioned concept, individual rights. But there is nothing utopian about individual rights. They are the sole basis of a just society. Name calling and equivocations will never stop rational men from making a stand in defense of their inalienable rights.
* The article never identifies its position as socialized medicine, of course. They don’t like that word. It sounds too much like what it is.