Dan Brock is a smart guy. He sums up one of the central problems with the U.S. health care system with five sentences.
“Americans are deeply ambivalent and inconsistent about health care costs and rationing. On the one hand, many like to pretend that rationing does not take place, but on the other hand they fear being denied beneficial care, in particular payment by their health insurance plans for care they need…Most Americans reject ability to pay as the basis for distributing health care…Most Americans, however, do not pay out of pocket the full, or even most, costs of the health care they receive. If insurance pays, it is hardly surprising that we do not support rationing which will have the effect of denying some health care to us.”
Brock continues to lay out a clever argument as to why rationing health care is not only inevitable, but ethical. Of course, not everyone–namely Joseph White–agrees with him. White understands that some rationing may be necessary, but he also sees a lot of room for improvement before we ever get to the point of telling people “No.”
It makes me a little sad to admit it, but I’d love to talk to both of these men at a cocktail party. Just the three of us, with enough vodka for two martinis, and only one olive.