31 March 2010

Healthcare Debates with Non-Comrade Papa

My wonderful, intelligent, Libertarian father and I have been having a spirited discussion about Obamacare--we both see the problems with the bill that was passed, but our views sharply diverge from there. Recently he sent me this article from Mises.org. An excerpt:

The United States once had the finest health-care system in the world, one based on the principles of economic liberty and the free market. That changed in a big way in 1965, when liberal statist Lyndon Baines Johnson secured passage of Medicare and Medicaid, socialistic programs that provided "free" medical care for the poor and elderly.

What Medicare and Medicaid did, decade after decade, was to place an inordinate demand on health care, producing a concomitant rise in prices all across the board. When government makes things "free," people tend to over-consume, which causes prices to go up.

The idea of "overconsumption" of healthcare is a bit vague in the article. It's disturbing to me that the idea of overconsumption of healthcare seems to be directly correlated to income level -- it seems that only poor people and poor elderly people are capable of "overconsuming" healthcare. The article suggests that once government policies were put in place to allow the poor to afford more healthcare, they immediately started overconsuming. So their healthcare consumption level was appropriate before, when their access to healthcare was radically restricted by their access to wealth? Therefore, if a wealthy person has multiple plastic surgeries, that's not overconsumption, but if a poor person has help paying for treatment of Type 1 diabetes, that's over (i.e. unnecessary, excessive, shouldn't happen) consumption?

It sounds to me like a value judgment that explicitly ties one's access to something necessary for life to one's access to wealth; people who have succeeded in making money have the right to access whatever healthcare they want to preserve and enhance their lives, while people who are from the less fortunate class are infringing upon others in their "overconsumption" of even basic healthcare.

I realize that the author of the article might be talking about things like excessive spending in end-of-life care, or excessive use of antibiotics, or other specific type of overconsumption. However, that's never stated in the article, and the inference is that even such "excesses" would be perfectly acceptable if they were the choice of someone with money. So really, it's not specific, expensive, and perhaps unnecessary medical practices that are the culprit; overconsumption of healthcare seems like a euphemistic way of saying "poor people who can't afford care should die rather than receive government funded access."

From the article, I see a class system in which only certain people have the right to live and the others are doomed to die unless some individual or group of individuals decides, out of their magnanimity, to help these unfortunates gain access to something to which they would otherwise have no right. Of course there are grayer scenarios where life and death are not in the balance; however, the article offers no provision for protecting the lives of people who don't have access to wealth and the advantages it confers...therefore, the question of access to healthcare is a question of life and death.

Am I missing something? How is "overconsumption" of healthcare defined? Who gets to define it, and for who?

No comments:

Post a Comment