Sunday, September 06, 2009

The Health of America, Part 18

Denver doctor Paul Hsieh on Pajamas Media counters the claim that market economics is rationing:
Health care does not magically grow on trees. Instead, it is a service that must be created by hard work and rational thought. The producers thus have the moral right to sell it to willing consumers on any mutually acceptable terms. There is no "just" distribution of medical services apart from the voluntary exchanges between producers and consumers in a free market.

Hence, if Bill makes more money than Joe and can purchase a $500 MRI scan that Joe can’t, then Bill deserves it. That’s not rationing, that’s justice -- just as it’s not rationing if Bill can afford a house while Joe must live in an apartment, or if Bill can afford steak whereas Joe eats hamburgers.

In contrast, government programs that attempt to guarantee "universal health care" are unjust. There is no automatic "right" to goods or services that must be produced by another -- that would be state-sanctioned theft or slavery.

Individuals are entitled to health care that they purchase themselves, is owed to them by contract (e.g., insurance), or is given to them as voluntary charity.

Whenever government attempts to guarantee an alleged "right" to health care, it must also control it. Bureaucrats and politicians must ultimately decide who gets what health care and when, not doctors and patients -- if only to control costs. This is true rationing, and it necessarily violates the actual rights of the practitioners forced to provide care on the government’s terms (rather than their own) and the taxpayers forced to pay for it.

The free market is therefore the antithesis of rationing. It respects individual rights, whereas rationing unjustly violates individual rights -- a crucial moral distinction.
I've said some of this before: rights are restraints on government set forth in the Constitution and laws, and healthcare isn't (yet) there. And I've observed that America already rations by price -- at least partly -- while supplying superior care. But Dr. Hsieh ably melds morals and measurement:
[I]t is the least-regulated sectors of medicine -- such as LASIK eye surgery -- that follow the typical free-market pattern of falling prices and rising quality that we take for granted with computers and cell phones. This can and should be the norm in all of health care.
Agreed. See also the Wall Street Journal here and here.

(via Instapundit)


Assistant Village Idiot said...

Life is unfair, sometimes dreadfully unfair. Attempts by governments to remedy this are always founded on the belief that fixing 100% of the general unfairness, or even 90%, is just an extension of the ease it takes to solve the first 10%. "Just do 9 or 10 times more of that. Problem solved."

Not so. The returns diminish rapidly, as even picking the low-hanging fruit changes the situation.

The accomplishments of those who struggle on despite difficulty are diminished by redistribution. If you rescue everyone up to $X, you have slapped the person who has sweated, risked, and deprived himself to make $X+1. All his effort and sacrifice - worth only $1.

It is one form of negative evidence, invisible evidence, that allows politicians to misperceive things this way.

Carl said...

Agreed--the first part of your comment is the 80/20 problem; the second is the Laffer curve.