Skip to Content.
Sympa Menu

internetworkers - Re: [internetworkers] Re: InterNetWorkers Digest, Vol 6, Issue 1

internetworkers AT lists.ibiblio.org

Subject: Internetworkers: http://www.ibiblio.org/internetworkers/

List archive

Chronological Thread  
  • From: rthigpen <rthigpen AT nc.rr.com>
  • To: "Internetworkers: http://www.ibiblio.org/internetworkers/" <internetworkers AT lists.ibiblio.org>
  • Subject: Re: [internetworkers] Re: InterNetWorkers Digest, Vol 6, Issue 1
  • Date: Tue, 01 Jul 2003 15:21:46 -0400

Benjamin Brunk wrote:

> Probably true, but it's also the BEST in the world. Other countries
> practice healthcare RATIONING.

In practice, scarcity rations healthcare resources everywhere. The US system simply rations these resources differently for different individuals, depending on wealth, insurance coverage, etc.

A key problem with this issue is that people don't tend to be comfortable considering healthcare in economic terms.

Personally, I'd say any system held up as an ideal would have to [1] produce appropriately high levels of care, [2] do so efficiently and [3] distribute care in an equitable manner.

The problem with these standards are that they are far from absolute known quantities.

It's nearly impossible to get any kind of agreement on [1]. In general, what is the value of a life, and how much should we spend to save it? Individuals' market behaviors express vastly different ideas of what constitutes a reasonable level of spending on healthcare. And yet there persists the idea that when "lives are on the line" that no amount of effort or spending is too high. This issue is political poison, and I don't expect to see it realistically addressed in the public forum within my lifetime.

Free-market based systems tend to do well on [2], but there are some serious kinks in how US healthcare markets operate. Much of the body of healthcare reform seeks to straighten out these kinks and use the resulting efficiency gains to squeeze more out of dollars already being spent. There are gains to be had here, but also powerful entrenched forces feeding off of those market kinks. These forces act to invoke our fears, and the public votes that fear.

Criteria [3] is another social issue, one that calls for value judgements.

Do you define equitable as a fixed amount of spending per person, per year? Or over a lifetime? Perhaps you prefer a needs based system? Or a cost conscious, needs based system? Should age be a factor(infants v. seniors)? Do the rich deserve better care? Is it wrong to take money away from the rich to provide more balanced levels of care across the board? Is it wrong not to?

These are some tough questions. But ones that our society/market is making defacto decisions on every day. But my belief is that we just might be able to organize a system that would encourage better decisions if we didn't shy away from these tough questions.

Just thinking out loud, I'd say US system seems to do pretty well on [1] and [2], but arguably has room for considerable improvement on [3].

Oh, and just so we're clear, I don't have a plan for changing any of this any time soon and I don't expect anyone even vaguely electable does either.

--rt












Archive powered by MHonArc 2.6.24.

Top of Page