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Single payer health care = death panels

by Greg Krehbiel on 13 August 2009

There is simply no way around it. Sarah Palin is exactly correct on this point, no matter what any bill says and no matter what any politician says.

If there’s a single organization that allocates health care resources, that organization will be forced to decide whether limited resources should be allocated to the young and healthy or to the old, infirm, incurable, etc. And that organization — it doesn’t matter who it is — will decide that certain people aren’t worth the investment.

It’s inevitable. Anybody who pretends that “single payer” will not result in a redirection of limited resources away from the old and the incurable is either stupid or lying.

Well, there is one other alternative. You could decide to ration health care along racial lines, or something like that. But the fact that some people will be left out in the cold is unquestionable.

The alternative to single-payer is to ration scarce resources the old-fashioned way — by who has the money to pay for it. Under this scenario, scarce resources will be thrown at any and every effort to add another week to the life of some rich old idiot while other people are left to suffer.

ISTM the health care debate comes down to some very simple principles.

The first is that we can’t provide infinite health care to everybody. It’s impossible. Which means that health care must be rationed.

The second is that there are two ways to ration scarce resources — by the market, or by some centralized bureaucracy.

The third is that a market-based solution is more likely to spur innovation because people have a profit motive, which has been proven (again and again) to be the most efficient way to innovate.

The fourth is that no matter how we ration health care, some people won’t get the health care we want them to have. That’s inevitable.

So the question is philosophical. Are you going to trust the geniuses in white coats with calculators, or are you going to trust the “invisible hand” of the market?

2009-08-13  »  Greg Krehbiel

Talkback x 6

  1. John Krehbiel John Krehbiel
    13 August 2009 @ 4:00 pm

    Just Tuesday, Mom told me that when the doctor saw Dad recently they did another CAT scan. She told them that he had just had a CAT scan a couple of days earlier, and she had a copy of the results in the car. By the time she got back from the car, they had already done another, presumably unnecessary, expensive, and (at least slightly) dangerous test.

    The reason? The market. Hospitals are paid according to what procedures they do. When resources are scarce, they do what pays them the best.

    Allocating resources does not mean that people will be killed, any more than allocating food inevitably leads to starvation.

    BTW, did you see this? It looks like Fox profits from the fearmongering and outrageous lying, but they’re giving the Republican party a bloody nose in the process.

    It’s really looking like the marginal notes on that legendary sermon- “Weak point here, talk louder.”

  2. Greg Krehbiel GregK
    13 August 2009 @ 4:47 pm

    The key word here is “presumably.” The doctors may have had a reason to do a second cat scan. And apparently the insurance company agreed to pay for it. It’s not as if doctors can do anything they like and insurance has to pay.

    But you’re right that in a market-based system, people do what makes the most money, which is what I said. If they make more money by keeping the rich old guy alive for another week, they do that rather than spend their time on the poor.

    I don’t get the point about the Fox news graph. You can chart any two things against each other. So what?

    And who says Fox news is “fearmongering” or lying? Only the extreme left, which is at least as guilty.

    Liberals are used to having the media as their own little sandbox and are all upset that somebody else’s cat has come to crap in it.

  3. Anonymous
    13 August 2009 @ 5:00 pm

    You know, all this market competition is inherently wasteful and unproductive. If there were only one soap company, one TV and radio station, one Newspaper, one publisher, one car company (actually, we’re well on our way to that), one Beer brewer, etc. things would be ever so more efficient.

    You’re right about allocating food. We should begin there immediately. Everyone should get Government Standard food rations daily (no wasteful hording allowed).

    No money wasted on Marketing and economies of scale would shoot through the roof.

    Why give people a choice when a panel of Scientists can come up with what’s best for everyone?

  4. Brent
    14 August 2009 @ 10:39 am

    Greg, I think you are flat wrong about rationing. The government will simply spend with the assumption there is infinite money (which is what they do in all other areas).

    Take the “rationing” of food stamps as an example: I do have a relative on food stamps. This relative uses the stamps to purchase endless steaks and other “cut-above” meals. I can’t afford to eat with such opulence. Again, rather than ration the government chooses to act as if money is infinite.

  5. Greg Krehbiel GregK
    14 August 2009 @ 10:59 am

    Brent — if you’re right, then we’re headed for deficits that expand at an exponential rate.

  6. Anonymous
    14 August 2009 @ 11:19 am


    Maybe Brent is right, medicare does cost 10x what it was projected to cost, even in constant dollars:

    But, deficits are _already_ increasing at an exponential rate, what’s beyond exponential?