Wednesday, August 12, 2009

Rationing

As is probably obvious, I've not been posting on politics much lately... there are a couple of reasons for this, but mainly I've found most of the political debates going on to be too maddening to comment about... but this "death panel" has to be addressed (even if it's still maddening). Setting aside the real crazy stuff, the general thrust is that including a public option in health care reform would lead to rationing, i.e. that some panel will determine whether your grandma gets a pacemaker. In a trivial sense, that's true... either Congress or, preferably, a board of experts will determine what services it will reimburse for in the public plan... just like any insurance company does. This means there will be services you can't get if you have the public plan, because nobody thinks it's a great idea for taxpayers to be on the hook for "free unlimited medical care for everyone"... we liberals just want to guarantee a minimum level of service for everyone. What's not clear here is how guaranteeing a minimum will lead to medical options suddenly disappearing. If you want something not covered by the public plan, why don't you pay for a fancier plan that does... or just pay for the service yourself? I mean, plastic surgery seems to be doing pretty well, and I'm not aware of any insurance plans that cover nose jobs. It seems odd for Randroids to have suddenly lost their faith in the power of free markets to supply services, but that seems to be the only way to read it.

I found this analogy by Matt Yglesias to be particularly illustrative of the illogic going on, since health care wouldn't be the only service with a "public option":
...your kid is entitled to go to a public school. They’ll teach him reading and writing and some science and history and probably Spanish or French or some such. But in the vast majority of places, you can’t have your kid taught Japanese at taxpayer expense. Again, though, we don’t live in a dystopian universe of “language rationing” in which it’s impossible to learn Japanese, you’d just have to pay someone else to do it. We of course could ban the market in private foreign language instruction, but it’s not clear why we would do that, and the existence of public sector provision of Spanish language instruction doesn’t in any sense imply a ban on the teaching of other foreign languages. What’s more, even if you’re incredibly troubled by the fact that today’s poor children don’t have the chance to learn Japanese in public school it’s still the case that eliminating public schools and lowering taxes isn’t going to leave those kids any better off. They still won’t know Japanese and now they also won’t be able to read.

Of course conservatives/libertarians don't like public schools either, but few are so brazen to propose we abandon it... and I doubt they'd find many takers if they did.

photo by flickr user austinevan used under a Creative Commons licence