Jul 16, 2009

The Logic of Rationing

Today, the New York Times Magazine has an article by Peter Singer, a professor of bioethics at Princeton, called "Why We Must Ration Health Care." Sometimes, it reads well: he makes a good point that we all, on some level, believe in rationing, since we all will say that at some point, the cost for a few extra months of life is not worth the cost to society. That's true. However, he leaves unaired and unconsidered the hugely important question of who does the rationing??

It is true that we all ration. We ration every part of our lives. I may want pizza tonight. However, if my checking account is running dry, I may not have the money to pay for it. The prices of the market ration me to rice and beans. I may want to spend the next three hours watching a long, involved movie. However, I may have to stop at the bank to make a deposit today before a check bounces. In that case, my time is rationed because of outside responsibilities. However, in both cases, I have the choice of whether to spend or not to spend, even if the limits of the choice are somehow forced on me through price or responsibility. I still have a choice, though.

On the other hand, sometimes, the government makes the choice for me. The government has told me that I am going to ration some of my paycheck and give it away. I must make due with the amount left for myself. Government-run healthcare will do what they do in Britain--the bureaucrats will determine what 'society' thinks a life is worth. In that sense, if you want a drug to extend your life, the government will tell you that the extra few months (or the potential of a cured or remissed disease) is not worth it to them or to your fellow citizens. Your life isn't that important.

I, for one, would rather be told by the price system that I haven't made enough money to extend my life than told by the government that I'm simply not worth it. Our current system has at least some (however minor) incentive to work hard and earn more money, since if I have more, I can afford to pay to live longer.

Government rationing is an insult to life and an insult to human dignity. Sure, you may say, so is poverty, but at least an impoverished person can make the decision to search for a job or to create a good that people may want. That's not saying it will be easy or necessarily successful, but the option certainly remains. Government rationing precludes that. You are told that you aren't worth it. Too bad.

No comments: