We’re Gonna Ration

The allocation of scare resources: Rationing.

There are a lot of ways of doing it; time, money, connections even luck.

Some of us think that rationing by money optimizes quality and supply.  Others think that rationing by time does the same thing.  I disagree:

SACRAMENTO — As the state moves to expand healthcare coverage to millions of Californians under President Obama’s healthcare law, it faces a major obstacle: There aren’t enough doctors to treat a crush of newly insured patients.

So, California is going to ration on time.  And one of the metrics that time based rationing optimizes is – low quality:

Some lawmakers want to fill the gap by redefining who can provide healthcare.

They are working on proposals that would allow physician assistants to treat more patients and nurse practitioners to set up independent practices. Pharmacists and optometrists could act as primary care providers, diagnosing and managing some chronic illnesses, such as diabetes and high-blood pressure.

Now, to be sure, allowing non-doctor health care providers could very well be positive; after all – why do we need an MD to refill a prescription for blood pressure medication?  However, I’m sure that California isn’t embracing this is an open-market mindset.  Rather, docs are just fleeing the medicaid business.  In fact, in California, only 57% of doctors are accepting new medicaid patients.

 

4 responses to “We’re Gonna Ration

  1. Health care is always rationed. Every scarce product is rationed. Right now the rationing is based on wealth – the wealthy get unlimited care and service. The poor often get very little or nothing. I don’t want wealth to be the guideline for rationing health care, but right now it is. Market driven rationing can be good, but can also be detrimental.

    • Health care is always rationed. Every scarce product is rationed.

      This is true. You can ration by money, time luck, political pull or almost anything.

      Right now the rationing is based on wealth

      Correct, kinda. We still use a very perverse incentive system where we are provided insurance as compensation and are removed from the “shopping” aspect.

      – the wealthy get unlimited care and service.

      Meh.

      My father was a teacher. He passed several years ago; tumor in the brain. He only ever attended Mayo.

      With that said, I am sure that I am in the top 10%, perhaps top 5%. And I will certainly have the same access to health care as anyone. Not until you get into “FU money” are people able to afford “unlimited”.

      Plus, and here is where the left wins the messaging, it has to be this way. Just several years ago blood pressure medication, the cure for the #1 killer, was unavailable to all but the most wealthy. Today you can get it delivered to your door for $4 a month.

      What used to be out of reach technologies are now common place. And yeah, today’s most advanced medications and procedures are pricing out the least fortunate among us, but those technologies will be common place in a short few years.

      I don’t want wealth to be the guideline for rationing health care

      For any commodity, wealth based rationing increases choice, supply, quality and innovation.

  2. Pino ,

    Maybe you should splain it based on electronics . Many of today’s wiz bang gadgets were only toys for the wealthy. Later on they became cheap enough for the poor . Most of today’s medical miracles simply would have never been developed under socialized medicine .

    • Many of today’s wiz bang gadgets were only toys for the wealthy. Later on they became cheap enough for the poor .

      Yup.

      We have devices that allow you to search the world’s libraries, communicate instantly to your mother half the glove away and pinpoint your exact location in order to help you find the nearest grocery store [selling blueberries in January grown in Chile unavailable to even the world’s wealthiest railroad barons]. All for a price that nearly everyone who wants one can afford one.

      55″ TVs, computers and video games.

      Amazing.

      And they say the market doesn’t work.

Leave a Reply

Your email address will not be published. Required fields are marked *