Libertarians Should Support Health Care Rationing
Wednesday, March 23, 2011 at 12:23PM The liberal view of health policy is that health care is a right, and the government has to figure out a way to make sure everyone gets it. Considerations of cost don’t come into the picture until government budgets get tight, and only then do they support rationing. That’s why they create open-ended entitlements, like Medicare and Medicaid, then think about cost control many years later.
The libertarian perspective begins with the fact that resources are scarce -- and that therefore rationing is inevitable. Then it focuses on who should do the rationing: individuals or government. Part of the libertarian critique of open-ended health care entitlements is that they create a tragedy of the commons, and make the necessary rationing harder to achieve.
So it’s strange to see libertarians criticize liberals for endorsing rationing – see here, here, and here. This is often, although not always, the basis for their opposition to Don Berwick - the director of the Center for Medicare and Medicaid Services.
When liberals recognize the need for rationing, our response should be “that’s what we’ve been saying all along.” It should not be “how dare you!”
The problem is that libertarians define rationing as something done by government. When it’s done by individuals we call it “making trade offs”. But that use of words often makes it sound like we don’t support cost containment. We should just use the “R” word in both cases. That lets us make a better case. Here’s an example, by Beth Haynes of the Black Ribbon Project:
“When you and I live within our means, we’re rationing. Although we usually think of it as budgeting, what we do is figure out how much money we have to work with, set our priorities, and then ration our resources accordingly…We get to do this, because we own those resources. Because what we would like to spend far exceeds what we can spend…we must privately ration.
The need to ration doesn’t change simply by pooling resources. In fact, pooling resources into common ownership makes planning all the more difficult. When medical resources are collectivized, we turn the industry which cares for us when we are injured, ill, or dying into a Tragedy of the Commons. Instead of Hardin’s example of cattle overgrazing the land, our infinite demand for health care leads to rising prices and a soaring national debt — unless we ration.”
Reader Comments (15)
They seem to forget that people can pay with their own money if hey really want the care.
Also related I think that as long as we have these Gov. organization they should act like private organizations as much as possible.
Because what we would like to spend far exceeds what -hot LV Monogram Motard bagswe can spend…we must privately ration.
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