Bioethicist Dan Brock—one of the radicals in a radical movement—pushes health care rationing over at the Hastings Center Report. (To give you an idea about his views: In Children of Choice, a book he coauthored with two other bioethicists, Brock argued that the state has “a eugenic role...as guardian of the genetic well-being of future generations.”)
In his column, “Rationing: Why It’s Ethical,” he writes that unless we do everything anybody wants, whatever they want, at any time they want, it is health care rationing. And since we are already rationing care, we might as well do it right. From his column:
As long as there is some limit to the resources available for health care, health care will have to be allocated to those who need or want it with not everyone getting all they need or want. Allocation in the face of scarcity is inevitable. The only to avoid scarcity in the health sector would be to provide all services to all patients who are expected to benefit, no matter how small and uncertain the benefits, and no matter how high the costs. This is clearly impossible.
Everyone might benefit from having a private physician accompany us when we travel, or from unlimited resources for research for diseases that we have or have some chance of getting. Everyone may benefit from having an MRI on the very tiny chance that a brain tumor may be causing the headache they are experiencing. Yet none of this would be possible without enormous increases in health care costs.
I call this the old “all or nothing” argument: Since everybody can’t have everything, we are supposed to believe, the state has every right to deny selected populations treatments they want based on their characteristics (age, disability, cognitive impairments, etc.)—this even if it means they will die.
But this is a false choice: Right now, we don’t allocate resources based on invidious discrimination. Rather, our primary problems are that some people—who are not legally denied treatment—often find themselves unable to get sufficient primary care due to lack of insurance. But even the uninsured are not denied life-saving treatment, but usually must obtain urgent care in unduly expensive emergency room settings.
This needs to change. But creating greater access for the relatively few can be accomplished without overturning the entire health care system and legally enacting a rationing scheme—which is medical discrimination by a polite name—either set in the stone of law or, perhaps worse, controlled by bioethicists of the ilk of Dan Brock who support quality of life judgments.
Still: I hope these kind of columns continue to be written, and the more the better. I sense people are waking up to the danger of the current proposals. That can only serve to help defeat Obamacare so that an ethical and more modest reform can be enacted.