The reason I wrote this post is that the people driving us towards this end are using the rationing of the private market as a reason to go with a government market.

That’s part of my problem though. They’re calling a highly-regulated market littered with perverse incentives inflicted by government a “free market” and then stating that the logical solution is government. The logic is mechanically correct, but the premise is completely false.

Right now the incentive structure set up by government inflicts strong pressure on people to turn the decision of “how much is my life worth” to an insurance company of their employer’s choosing. The regulatory structure allowing only certain types of insurance means that once insurance is purchased, you are turning that over. Risk pooling doesn’t have to work that way.

The market is in no way free, and I believe the way we need to frame this is that any nationalization plan is taking the worst aspects of what we currently have and inflicting them on everyone.

“Instead, we are barreling towards forcing people to allow the government to decide how much they’re worth. It’s sick.”

You’re entirely right. The reason I wrote this post is that the people driving us towards this end are using the rationing of the private market as a reason to go with a government market. They’re conveniently avoiding the idea that government will ration (i.e. when right-wing folks talk about Canada’s wait times, they pooh-pooh it as if it’s not real data).

I think you’re right that we need to have a serious discussion in this country that the choices aren’t between the bad system we have and the bad government proposals, but that we need to have a market system that is more transparent (and correspondingly less employer-based) that allows individuals to see the choices being made and have some say in those choices.

We’ll never get that discussion, though, if we let the statists succeed in their suggestion that the choice is between a rationing private market and a non-rationing fairytale government system.

There is one kind of rationing we all do every day, for food, clothing, gas, electronics, and a thousand other things. It’s called operating in a competitive free market. We’re generally OK with this kind of rationing because we are the ones deciding how much these items are worth to us.

Yet we willingly hasten to let a complete stranger decide how much our life is worth to him. How much more is the insurance company willing to pay out? How much should the elderly be helped when the government could be helping productive younger citizens?

Our preferences don’t enter into these decisions, so we are often unhappy with them. The insurance company sucks, we say. The government is screwing us because we’re too old, we say. Instead of doing something about it, we suck it up and say that’s just how the world works.

The only moral rationing of health care is that done by an individual on his own behalf or by a third party of his choice. There is little to no moral rationing happening today because people have very little choice about who does the rationing for them. It’s either the government, whose authority is inescapable in this regard, or an insurer picked by an employer, where the law aligns it so that the cost of opting out makes the choice unrealistic.

Our objective should be to get the rationing of health care back into the hands of the people, and supporting risk pooling mechanisms that align with that goal. Instead, we are barreling towards forcing people to allow the government to decide how much they’re worth. It’s sick.

What will be rationed – and is already in short supple is Quality Healthcare. Sorry but unless one opens the flood gates to trained immigrants from other countries (and there is almost always a severe language barrier)there are only so many truly excellent healthcare practitioners available and when their earning potential drops they will move to more lucrative fields of endeavor.

Hence we have more people serviced by fewer good practitioners.