Dr. James Schroeder wrote an important article for Friday’s Free Press of Grand Junction. He responds to media hype about the “Grand Junction Model” for health reform.
[A] large study done at Dartmouth University looking at variations in Medicare spending was released in April 2008…. The Dartmouth Atlas is being overstated. … All the data showed is that some hospitals spent more than others. … The death rate in this particular study was 100 percent. … The only logical conclusion to be made is that Grand Junction is efficient at getting people to the point of death.
Hang on to your wallet, because the Dartmouth Atlas will now be touted as showing that some regions (Grand Junction being the shining example) are “more efficient” at delivering health care while saving money! This in turn will serve as the anvil upon which health care spending throughout the country will be hammered into line by a federally controlled health care system. …
The current administration advocates a system that will take those difficult value judgments out of your hands and put them in the hands of a nice, caring, compassionate bureaucrat. … The (barely) unspoken message is that you have a duty to die cheaply in order to save money for everybody else. …
Please read the entire article for yourself.
I have but a couple of nits to pick. Schroeder writes, “Health care services are finite, just like any other commodity. At its core, the entire health care debate boils down to distributing a finite number of dollars for the purchase of health care services for a diverse population of 300 million. The only way to do that is by allocating expenditures and resources, or in other words rationing.”
That paragraph is wrong for two reasons. First, while the availability of doctors, hospitals, drugs, etc. at any given time is limited, the amount of health care services can change dramatically over time. Today vastly more health care is available than was the case a century ago. One of the effects of socialized medicine would be to reduce the amount and quality of health care available, particularly as the better doctors left the field and the better students looked for careers elsewhere.
Second, “rationing” pertains only to political distribution of goods or services. For example, if you walk into a grocery store and purchase hamburger instead of steak, that’s not “rationing;” that’s a rational response to prices. If you choose to go to an urgent care office rather than an emergency room, that’s not “rationing” the emergency care. A free market involves willing agreements among buyers and sellers, consumers and producers. That’s not rationing. Rationing is when politicians and bureaucrats decide who gets what, and how much they get.
A free market in health care involves no rationing. The partly-socialized medicine we live under today involves considerable rationing. A completely socialized system involves nothing but rationing.
Mr. Armstrong,
Thanks for the link.
To expand on my use of the term rationing, I recognize the general common usage as implying governmental imposition of restrictions. I was using a different sense of the word to make my point. Webster’s defines a ration as “share especially as determined by supply”, (which implies some entity determines the share). Webster’s has three definitions of the verb form of ration, the third of which is “to use sparingly”. The sense I was going for was to make the distinction that with a finite resource, the question boils down to who is making the decision of “fair share” (or ration), whose resources are used to purchase the resource, and who makes the decision (or rations) how to use the resource sparingly. Another way of saying this would be to use the phrase “allocation of resources” and distinguish between “self-allocation” and allocation decision made by a third-party (i.e. government). Largely a semantic argument, but I find that using a twist on a commonly-used phrase sometimes makes the reader re-consider the meanings.
Thanks again.
Jim Schroeder