Monday, June 22, 2009

The morality of health care

Health care can be a fairly emotional subject, which shouldn't be surprising given that it quite literally involves matters of life and death. As such an emotional -- and oftentimes personal -- subject you often see morality injected into the debate.

Frequently advocates for a single-payer (i.e. government-run) system will justify their approach by arguing that the alternative -- allocating health care only to those that can afford it -- is an unconscionable arrangement for a civilized society.

I think it helps to point out, however, that rationing and denial of service occurs in every conceivable health care model. Even in single payer systems patients are frequently denied care or -- more commonly -- placed on a waiting list. Resources are limited and not everyone can get what they want or need at the time the exact moment they desire it. There is only so much money to pay for it all.

Indeed, we see this played out in the health care debate with single payer advocates citing statistics about people bankrupted in the pursuit of life-saving health care while those wary of an interventionist approach respond with their own stories of people dying after being placed on waiting lists or, more mundanely, extracting their own teeth. Both sides are right.

It seems to me that given the reality that rationing by bureaucrats is part and parcel of the single payer system the smarter approach is to focus on controlling health care costs and making it cheaper, which would make it available to more people. The best way to do this is the expansion of competition and expanded reliance on the free market, which has consistently shown the most promise in reducing prices and increasing quality. It is the use of those principles, not expanded regulation and government intervention, that will help provide Americans with high-quality care with lowered cost.

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