The Healthcare Elephant

As the debate rages regarding how to revamp our (US) healthcare system, there are some plain and simple truths that everyone had better start acknowledging (these are the elephants currently being ignored).

Healthcare rationing is a fact.  We rationed healthcare in the past.  We do it today.  And we’ll do it in the future.  The question is HOW it’s rationed, not IF it’s rationed.  We ration food.  We ration shelter.  Capitalists ration.  Socialists ration.  Communists ration.  It’s the “how,” not the “if,” that differs.

Today, healthcare in the United States is rationed on the basis of economics, using the capitalist system for the most part.  People that can’t afford healthcare coverage don’t get it (not strictly true because we already have many government programs like Medicaid to fill gaps).  Whether that’s fair—or right—is an entirely different question.  It’s essentially the same way we decide who gets a BMW and who doesn’t.  What the healthcare debate is really about is whether capitalism is the best way to ration healthcare or whether we should use a more socialistic approach.  No one wants to come right out and say that rationing is—and until we achieve immortality, will be—the essence of the debate.  It is a BIG elephant.

So when the question arises, “Are we moving toward socialized medicine?” the answer is plain and simple—“yes we are.”  Is that good or bad?  I don’t know.  Anytime one is more in favor of less capitalism, the direction ends up being towards more socialism.

It’s also important to understand that rationing is absolutely necessary and inevitable.  We simply cannot consume unlimited healthcare at will. And until we achieve immortality, our demand for more—and better—healthcare will be endless.  You see, unlike other things, we’re not willing to wait for healthcare costs to come down.  If a new generation of televisions (say, plasmas or LCDs) is out of our reach, we save our money until we can afford it, or we decide to forego it altogether, at least until prices come down.  With healthcare, we don’t want to wait (and often can’t).  The demand for healthcare drives the ultimate need for instant gratification.  Our desire for the television may ultimately fade, or it can be satisfied at a later date. If you’re dying, the demand for a cure has a time limit on it—and only fades when you have faded out of existence.  It can’t wait for you to save your money and you can’t wait for prices to come down.

The solutions to our healthcare challenges will not feel like solutions—because the problem we all WANT solved, can’t be solved.  What we’re looking for is an end to the “want” for more and better healthcare and until we achieve immortality, that’s not going to happen.  The real solutions are going to be real compromises. And when it comes to politically and emotionally sensitive issues, compromise is never easy.  Until we kill the elephant, we can’t even begin the process of real and meaningful compromise.