• When the truth slips free – ctd.

    I’m always surprised at which posts draw heat and how they do so.  I’ve been getting a lot of email about this post.  Most of it is in the form of gloating, as if I’ve “lost” because I showed that the government is rationing.

    Um…  no.

    First of all, please get over the idea that this is a game one side wins or loses.  This is much too serious.

    Second, please get over the idea that I’m on some imagined side.  I’m not a partisan, nor do I believe “all government is good” as some of you seem to think. I will call out government for things I think are bad just as I will call out the private sector.  We are all part of a big health care system that I think is terribly flawed.  When someone says that we don’t need health care reform, they believe it’s all good.  I don’t.

    Third, as I told a commenter (perhaps over-excitedly) if you think this sort of rationing isn’t happening in private insurance as well, I’ve got a bridge to sell you. Our whole system rations by ability to pay. We hear about it more from government because that information is public. Private insurance more often gets to keep its books closed. That doesn’t make it better.

    Many of you are using this example to say that government should get out of health care.  They are rationing.  They are the ones denying you care.  They should get out.

    Really?  We’re talking about the permanently disabled here.  These people are no longer gambles; they are absolutely, positively going to cost a lot of money.  What free market private insurance solutions do you propose for them?  Which private insurance companies are going to compete for their business?  No one wants to insure a guarranteed loss.  It has to be government.

    Do you have another solution?

    • I don’t think you are partisan or that you think “all government is good”, but between these two posts you’ve said:

      “They will tell you that in this country, we don’t ration. They will tell you that in this country no one waits for care care because they are too old or because they are deemed not worth it.”


      “When someone says that we don’t need health care reform, they believe it’s all good. ”

      What serious person believes either of those things?

    • You are joking, right? Do I really need to link to all the people who have said that we don’t ration in the US and that they do in other countries?

      Do I really need to link to the many people who claim we have the best health care system in the world (and therefore don’t need to fix it)?


    • When I and a group of fellow physicians met with our congressman, Republican, to talk about health care (we have done this a few times) he showed us some of the Luntz talking points. Chief among them was the word ration. It is an emotionally charged word. When used within the proper economic context, we all ration, but most people think of it as the government withholding food. I try to describe it as our inability to pay for unlimited care. Not sure what the best approach is, since it will still be distorted.


    • Aaron, yes really. Notice I said “serious person”.

      Of course there are a lot of people out there with ridiculous beliefs on our health care system. This goes both ways, people who think it is totally awesome and doesn’t need any fixing, and people who think we can magically transform to single-payer overnight and all of our problems would disappear.

      But it doesn’t do us any good to focus on those people, and one of the things I’ve always liked about both this blog and your old one was a willingness to avoid engaging in that type of counter-productive discussion. You and Austin have had very useful and enlightening back-and-forth with people like Avik Roy, and those discussions are great for advancing the debate.

      I am a firm believer in seeking out the strongest and most reasonable arguments from the “other side” of an issue and engaging with those and ignoring the low-hanging fruit of uniformed people making weak arguments. You and Austin do that better than most (even though I sometimes disagree with you), so I was disappointed to see that original post.

    • gah, “uninformed people”, people wearing uniforms can still make strong arguments 🙂

    • AB,

      While I appreciate the compliments, I still think you’re making false equivalencies. People who are generally taken very seriously make these claims all the time. But I’m not interested in going in circles on this one, so let’s agree to disagree,