Trinity is amazing. This morning we had a great discussion in policy about an article entitled "The Tragedy of the Commons." If you have never read it, google it and you will find it. You might be thinking, Alex, you're in a healthcare administration program, why are you taking about peasants owning cows. The same tragedy occurs in the medical commons. When people strive to maximize their utility through living a long life and using medical resources, there is little to no consideration for how others are effected. This comes because people do not see medical resources as scarce.
In America, we have this desire to live as long as possible and are willing to pay or do whatever is necessary for that to happen. Why am I willing to pay so much? Because to me, health care is not scarce. It is everywhere, hospitals, docs, outpatient surgeries, and the list goes on. I have the ability to pay for all of this.
My professor provided an example of his father. This example shows the generosity of Medicare. His 94 year old dad was having some heart trouble and his doctor recommended a pacemaker. Medicare approved it. Now it is easy to say yes give him the pacemaker, and I don't mean to bring up a huge ethical dilemma, but to say that a 94 year old man can spend tens of thousands of dollars on a procedure that he doesn't really pay for, is difficult to fathom.
Like my professor's father, very few of us pay the cost of health care. Many people reading this blog are still on the parent's health insurance and have no idea what a doctor's visit actually costs. This gives us an idea that medical resources are infinite.
So the question is, what policies can the government come up with to create scarcity in medical resources. From a friend I heard Britain, if you are a dialysis patient and turn 65, they no longer pay for you to undergo dialysis. Then you have two options...1)die (pretty blunt, I know) or 2)pay out of pocket. In an exact sense, medical resources are rationed.
As predicted, you are probably saying, who in their right mind would let that happen? Then arises the moral and ethical debate, and the vicious cycle begins.
More and more I have learned there are often more questions than answers in health care. This post is not to give you answers. Hopefully it prompts questions and thoughts in your own mind and you want to share comments. Our system is flawed in many ways. On the other hand, our system is great! We have great technologies and the quality of care is getting better and better. These are concerns I want to tackle throughout my career. Thanks for reading!
I am going to start off with your question: What policies can the government come up with to create scarcity in medical resources.
ReplyDeleteIt is my feeling that the Government has spent half of its existence creating the illusion that there is no scarcity in healthcare. I find them incapable of making any practical or ethical decisions of any kind. (that is for another day) In a system where the burdens of health care are placed upon the few while most enjoy it freely creates artificial demand and as a result reduced supply and therefore higher costs. This I believe is the problem with the system.
So since we have to deal with limited supply anyway, I pose this question:
Why is it better for the Government to choose how to ration and not a person’s economic status? In a purely evolutionary take on it, by letting the free market decide who gets what, the fit will survive. By letting the Government do it, you propagate waste.