Feldstein's Complaint

Martin Feldstein, a Harvard economist, rants in a Wall Street Journal article that health care reform would remove free choice and allow the government to "ration" health care.

The Economist magazine has an article that points out how stupid Feldstein's rant is. Here is the key bit:

The nub of the matter is this—government can afford to provide basic coverage to everyone, but it can't afford to provide every treatment everyone may want to everyone who wants it. It must therefore decide how to limit its expenses, and it can leave open the option of using a private practitioner to those who are denied care based on a cost-benefit analysis. Or government can provide coverage to no one, and those who cannot afford a treatment—effective or not—will go without. Those people will be just as fine as they'd be with treatment in some cases, they'll suffer in others, and occasionally they'll die because they couldn't afford coverage.

That's the nub of it, really. Faced with the prospect of a plan that provides effective treatments to everyone but forces people who want relatively ineffective treatments to pay for them on the private market, Mr Feldstein says he'd prefer a system where people who are unable to afford effective treatments don't get them, calling concern for those unable to pay for treatments "misplaced egalitarianism".

It's all well and good to let the market allocate televisions. Many people live happy lives without televisions, and lack of a television hasn't ever killed anyone. Attempting to provide a basic level of access to television to every American would be misplaced egalitarianism. I would have thought Mr Feldstein could understand the ways in which the market for televisions is different from that for health insurance.

The real world rations things. You can ration based on blatant power (he who has the gun, rules). You can ration based on wealth (he who has the money gets what he wants and the poor are left with nothing). Or, you can ration based on some system that tries to get the best outcome based on cost and knowledge about the state of the art (that's what most public health care system try to achieve).

None of the public health care system can prevent a rich person from buying platinum care. The rich can always buy what they want. What the public system does is makes sure that the poor are not left with nothing. But the ranting right wing in the US calls this "socialzed medicine". And they have managed to convince a fair number of fools into believing this ridiculous smear campaign.