Sunday, July 19, 2009

Rationing Health Care

The 3rd rail in the discussion about health care reform is rationing. Princeton ethics professor Peter Singer presents a cogent argument for the need for rationing in a NY Times Magazine article, Why We Must Ration Health Care.

I won't rehash his arguments except to say that though the use of a joke about prostitution he notes that this is all about a negotiation about how much we will spend for a particular outcome. Britain’s National Institute for Health and Clinical Excellence (NICE) which I have blogged about earlier regarding treating low back pain. NICE has said that for a year of extra life they suggest spending up to approximately 49 thousand dollars. I know this seems harsh but as I said it is about a negotiation. Most would agree that 10 million dollars is too much for our economy to pay to extend a life one year. Obviously, Bill Gates or others will limitless finances are free to do that but clearly no country can afford to spend that much money for only 1 year of life. Everyone would agree that spending $100 to extend a life one year is easily worth it. So the difference between these two are just a matter of negotiation.

One fact that Singer ends with is a refutation of the conservative argument that health care reform will result in the US getting stuck with health care that the Britons or Canadians have, as if that is a horrid outcome. Singer presents the results of a Gallup poll on how happy are US, UK and Canadian citizens with their health care. Seems that if this poll is definitive, we in the US would be fine with a UK or Canadian style of health care, not that those are the only models to choose from. I guess the conservatives hope that we'll just listen to their fallacious arguments and believe them. Fear mongering is a live and well on the right.

Details on the Gallup poll can be found here.


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