I’m neck deep in grant reviews and I promised myself I wouldn’t get distracted, but I can’t let this pass.
Avik Roy has returned from his self-imposed sorta-hiatus from the blogosphere to pen a piece on the return of death panels. He has defended the positions of others on this before, and I simply disagree. I think he’s twisting the words of others to try and make them rational. They’re not. And he‘s doing it to those on the Left as well:
The Left’s solution is rationing: the government should determine when individuals are seeking care they don’t need, and prevent them from obtaining it. The Right’s solution is privatization: let individuals pay for the care they want, even if that means that some people are able to afford more care than others.
I’m sorry, but this simply isn’t true. I think he’s accurately representing the position of many on the Right. But not the Left. I would say that the position of many on the Left (and it’s the “Lefty-Left”) is that government should determine what care individuals need and pay for that. For everything else, let individuals pay for the care they want, even if that means that some people are able to afford more care than others.
Notice the difference? Avik implies that the Left wants to tell you that you can’t have care you’re willing to pay for. That’s simply not true. Avik implies that the Left wants to let the government tell you that you can’t have things even when you want to pay for it out of pocket. I have met no one – at least no one serious – that wants this.
Avik furthers this argument by once again cherry picking the UK:
Donald Berwick’s nomination to head CMS was controversial precisely because he is a passionate advocate of the British system, in which there are indeed death panels that prevent patients from receiving life-extending therapies for cancer, blindness, and other conditions.
Here’s the thing. No one in the US is advocating we adopt the health care system of the UK. No one. Even the self-described socialist in the Senate isn’t trying to get us the NHS. Those in the “Center-Left” brought us the PPACA, which is giving some people public money to buy private insurance. Those on the “Lefty-Left” want Medicare for all. And, under Medicare, if you want to get care not covered by the government, you absolutely, positively can pay for it yourself and get it.
I think Avik knows this. And that’s what frustrates me. I’ve corresponded with Avik and found him to be a reasonable guy. But he’s making straw-man arguments in order to demonize the views of those who disagree with him. He’s crying “Death Panels!”.
Here’s what I believe to be a more accurate representation between those on the Left and those on the Right:
- I think some on the Left want to use public money to pay for care, but think we can have a panel of experts (which should include physicians) try and determine which care isn’t worth the money and stop spending as much public money on that. This will mean that if individuals want to get that care anyway, they have to pay for it themselves.
- I think some on the Right want to spend less public money on all care. This will mean that individuals will pay for the care they want themselves, even if that means that some people are able to afford more care than others.
As I’ve said before, to some out there one of these is evidently a “death panel” and the other is a great idea. Personally, I believe the first is more sensible and the second is regressive; others disagree. That’s a debate I’m willing to have.
But no one is advocating what Avik suggests. I wish he’d stop saying they were.