My point remains that having government interfere with an individual patient and their doctor's discussion about what is medically prudent for that patient is wrong.
Having the government control what the doctor can do (beyond the extreme cases) is wrong, but having the government decide what it will pay for? Not so much.
If you assume the government will take over medical payments and actually disallow both private insurance and paying out of your pocket, than deciding what it will pay for is pretty close to deciding what the doctor can do. But the problem there is not the government saying "we will pay for X, half of Y, and not Z", the problem there is the government outlawing other forms of payment.
Also you'd have a problem if the government didn't take over care, but controlled what private insurers could pay for.
What about a young woman I know whose grandmothers both have a history of breast cancer? She is staring down the barrel of a loaded gun. Lane3 wants her to risk death because the government doesn't want to pay for mammograms until the patient is over 50.
How expensive is a mammogram? I don't think its a huge cost. If the government won't pay, maybe she could pay out of pocket, or private insurance would pay.
Also it may be that the number of mammogram's we give out is not a serious health benefit. You do some good (earlier detection of cancer), along with some harm (radiation from the mammogram can contribute to cancer or other problems), at some cost. Adding the harm and cost, and perhaps we shouldn't do as many of them. I still don't think the government should outlaw them, if someone wants one every six months from age 20, that's their business, but I wouldn't say its a great injustice if the government doesn't normally pay for it.
Rationing in the broadest sense of the word will happen if you assume health care is an economically scarce good
When government is the single payer it will be.
It already is, always has been, and will be so for the foreseeable future. Economically scarce goods only implies that there isn't a virtually unlimited free supply. That something isn't a "free good".
"The free good is a term used in economics to describe a good that is not scarce. A free good is available in as great a quantity as desired with zero opportunity cost to society.
A good that is made available at zero price is not necessarily a free good. For example, a shop might give away its stock in its promotion, but producing these goods would still have required the use of scarce resources, so this would not be a free good in an economic sense."
en.wikipedia.org
Drinking water, steel, cars, radios, houses, concrete, roses, etc. are all scarce goods even though their pretty common. So is manual labor, even though there are about 6.7 billion people in the world, most of whom can do at least some manual labor.
When government is the single payer it will be.
I see your pessimistic.
By single payer, do you mean that in the loosest sense of the word, that there is a national government insurance organization that dominates the market, or do you mean truly single payer, that all other forms of insurance, or perhaps even all other forms of payment, are outlawed?
Canada did ban other insurance (at least for what the national insurance covered) but the trend there is towards allowing private insurance. The UK has socialized delivery of healthcare, not just national insurance, but it allows private health care and insurance on the side. Other rich countries tend to be less extreme than those two. I don't see the US jumping past Canada and really outlawing private health care payments. |
