A Stitch in Haste

To review: Health care, however defined, is a scarce good like any other good or service. And like any other scarce good or service, it must be rationed. The only question is how it will be rationed — by private market forces (perhaps bounded by a minimal, humane social safety net for the truly incompetent) or by politicians and bureaucrats.

Some anecdotes describing the latter system recently crossed my aggregator.

ITEM: For example, rationing can be — and apparently is — age-based in Britain —

Hospitals have been accused of age discrimination after a study found that they failed to provide basic standards of care to many patients aged 50 and over.
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The researchers quantified what treatments for 13 different conditions — including heart disease, diabetes, stroke, depression and osteoarthritis — could be expected.

In total, these numbered more than 19,000 different opportunities for care to be delivered to people, but actual care was given only in 11,900 (62 per cent) of those cases. Scores on the quality of care ranged from 83 per cent for heart disease to 29 per cent for osteoarthritis.

Arthritis is a low-profile, unglamorous, common ailment among the elderly. No one “dies from arthritis.” But people do suffer — literally — from it; in the worst cases it can agonizing and totally debilitating.

Yet if there is a “right to health care” in a “more enlightened” society that offers “universal coverage,” then the “care delivery ratio” for arthritis ought to be 100%. Indeed, the care delivery ratio ought to be 100% for everything — in all instances, for all people, in all circumstances.

More:

The researchers found that substantially more care was provided for general medical conditions (74 per cent) than for geriatric conditions (57 per cent), including falls, osteoarthritis, urinary incontinence, cataract problems, hearing problems and osteoporosis.

Of course, in the New American Gerontocracy™, those ratios are, or likely will become, reversed: It will be the elderly and their various ailments that will enjoy above-average care delivery ratios, while other people, other ailments and other circumstances settle for lower percentages — sometimes even zero.

True “universal health care” is a myth. A perfect 100% care delivery ratio is simply not possible in any economy. The ratio must fall below 100% sometimes. The question is only which conditions, which people, which circumstances. And who gets to decide.

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ITEM: A Broadway musical once asked, “How do you measure a life?” The NHS measures it in pounds sterling —

The National Institute for Health and Clinical Guidelines (Nice) has ruled for the first time that saving a life cannot be justified at any cost, in a review of its ethical guidelines.
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Nice is facing growing criticism over the number of drugs it is now rejecting which are available throughout Europe and in America. Last week, it refused to sanction four kidney cancer drugs which can double life expectancy.
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In a report on “social values judgement” the regulator says: “There is a powerful human impulse, known as the ‘rule of rescue’, to attempt to help an identifiable person whose life is in danger, no matter how much it costs. When there are limited resources for healthcare, applying the ‘rule of rescue’ may mean that other people will not be able to have the care or treatment they need.

I say again: The only question is how health care will be rationed — by patients, physicians (and, yes, insurance companies), or by politicians and bureaucrats.

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Both links via John Ray.