The New York Times has a front page story today on the British system of rationing. It’s a long read, but an important one. And right up towards the top, you see why. The British system has made a choice. They have valued six months of life at $22,750. That’s all they can afford, they say. So here’s the question: In a government system in the US, should the government be on the hook for more than that? If six more months of life—not a cure, but a six month reprieve-- would cost $50,000, should we pay for that, keeping in mind that that money is coming from priorities like education and food stamps and wages increases? Or should we have limits? Should the system itself ration?
The real question, however, is who decides? Do you really want some government official deciding whether you get $23,751 worth of care?
What I find particularly objectionable about the British rationing system is the effort they make to prevent private funding. If I can afford to spend $100,000 to buy a six month reprieve, why should the government tell me not to do so? Yet, in the UK, opting for private funding of a single treatment apparently can result in your exclusion from the rationed care system in its entirety.
Liberty not egalitarianism is the basic principle on which the USA was founded. As Andrew Sullivan comments:
One reason I’m a conservative is the British National Health Service. Until you have lived under socialism, it sounds like a great idea. It isn’t misery - although watching my parents go through the system lately has been nerve-wracking - but there is a basic assumption. The government collective decides everything. You, the individual patient, and you, the individual doctor, are the least of their concerns. I prefer freedom and the market to rationalism and the collective. That’s why I live here.
Be Careful What You Wish For.