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January 27, 2008

When Government Runs The Health Care System....

... it gets to make choices about what -- and whom -- to cover. A survey of doctors in Britain's National Health Service show that a significant percentage of providers want government to cut off benefits to the elderly, the obese, smokers, and others:

Doctors are calling for NHS treatment to be withheld from patients who are too old or who lead unhealthy lives.

Smokers, heavy drinkers, the obese and the elderly should be barred from receiving some operations, according to doctors, with most saying the health service cannot afford to provide free care to everyone.

Fertility treatment and "social" abortions are also on the list of procedures that many doctors say should not be funded by the state.

The findings of a survey conducted by Doctor magazine sparked a fierce row last night, with the British Medical Association and campaign groups describing the recommendations from family and hospital doctors as "out­rageous" and "disgraceful".

On one hand, this makes sense. After all, the taxpayer has to foot the bill for these procedures and these patients. Why should some taxpayers have to subsidize bad behavior? If people choose to smoke, why should non-smoker taxes support the consequences of that habit, especially when it makes non-smokers wait longer for their own health care?

This exposes the fallacy of "free" health care. There is no such thing. Someone has to pay the bills, and it can either be the patients themselves, the insurers, taxpayers, or a combination of the three. No matter what happens, each of these payers will act in some way to ration care, especially regarding cost. The question is which kind of rationing allows for the best access for the individual, and which threatens the greatest intrusion on freedom and personal choice.

In a single-payer system, the government can extort individuals over their personal choices, and even have some rational support for that extortion. In the name of "fairness", they can determine that some people are too old to invest in their care. They can determine that others eat badly and therefore don't deserve to take resources away from people who eat better. At some point, that could translate into preferential treatment for vegetarians or against vegetarians, depending on the whims of the bureaucracy at the moment.

Do you want government to tell you that your mother or father are simply too old to matter anymore? Would you like to have that happen in a system where either the private care choices are out of reach because the government has removed all of the private insurers from the market, or they don't exist, as in Canada? Eventually, state run systems fall back to the bread line model, as they did in the Soviet Union, and someone has to start making choices about who gets the bread. (via Memeorandum)


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