Why Obamacare Will Lead to Rationing of Medical Services
No Matter How Many Promises Democrats Make
Sarah Palin took a lot of heat for her comments on the federal government setting up so-called "death panels."
Yet few have commented on the fact that insurance companies in America already have "death panels." Everyday, insurance companies and hospitals decide who is going to get necessary lifesaving treatments—and who isn't.
But one thing Palin is correct about is that this process is even more pronounced in countries with universal healthcare.
In his book, The Undercover Economist, Tim Harford reveals the dark underside of the healthcare system currently in place in Great Britain.
In Britain, the National Health Service (NHS) offers "free" care to all citizens. But as in Canada, "free" healthcare means strictly limited healthcare where government bureaucrats, not patients or their doctors, decide who does and who does not receive treatment.
Here's one example.
The Royal National Institute for the Blind wants the NHS to provide photodynamic therapy for the blind using a new drug and laser treatment. The NHS has refused because of the expense.
In 2002, the British government ruled against such treatments unless both eyes are affected. In other words, the NHS literally doesn't care if you are blind in one eye.
It's easy to condemn the NHS, but keep in mind that just because it is a government agency, it too has limited resources and an unlimited number of ways to spend it.
So who decides what gets spent and on whom?
The NHS decides based on a formula called the Quality Adjusted Life Years (or QUALY).
In the best tradition of British utilitarianism, the QUALY score attempts to quantify moral judgments according to a fixed deterministic formula:
"A treatment that saves 10 years of life is better than a treatment that saves five years of life," the economist Harford explains. "A treatment that gives somebody 10 years of able-bodied life is better than a treatment that gives somebody 10 years of life, but in a coma. The value-judgments involved are extraordinarily difficult."
Indeed. But as in most things, the devil is in the details—and in the essential question, "Who decides?