3 ms·

There is no need for magical thinking, but you do need to take a step back and look at the bigger picture. Many countries view it as a much simpler problem of

There is no need for magical thinking, but you do need to take a step back and look at the bigger picture. Many countries view it as a much simpler problem of optimizing their society as a whole: 1. There are N doctors & medical supplies. 2. There are M people that have an illness. 3. How can we as a society make sure that these M people don't die? Then, you (as a society) make up a set of rules and incentives and economic structures so that longterm you are able provide treatment to M people and define what "adequate" means based on your resources. If someone wants more than "adequate" treatment, you add some way to pay for things. Ideally in wealthy countries these are never actual medical necessities. Once you're there, you just solved 80% of the problem and nobody dies just because they weren't rich. Of course life is messy, so you need to have some resources to spare for edge cases and exceptions to the rules out of compassion, where there are e.g. experimental treatments, etc. It is true that there will be limits as to what you can provide, as treatments will cost money and disability-adjusted life years gained will go towards zero the older you are. But that is also the case when you have a "pay money, get service" system, even if you are extremely rich you will not be able to extend your life forever. The rationing happens either way, and in most countries you would need to be extremely rich to be able to come out on top. Actually you would need to already be born rich in order to be able to pay for anything that comes up in your childhood. That is extremely cruel, but unfortunately a reality in some places in the world.

roenxi 6y ago
You're avoiding the question of "how do we choose who doesn't get access to a scarce resource" there though. It is all very well to say "we'll prioritise illnesses that kill people", but pretty much every death can be traced back to an illness. Even the ageing process could reasonably be defined as an illness, it probably will be one day if the world hasn't gotten there already. That leaves the unlimited nature of healthcare as an open problem. We all die, and arguably anything other than an accident death is people dying sick. > Then, you (as a society) ... define what "adequate" means based on your resources. Your country, and the US if if isn't your country, has already done that. The political process asked that question with Obamacare, for example. That is pretty recent accounting of what resources are available and what the people thought they could do with them. And you've not grappled with the key question - we aren't going to use wealth to decide who gets healthcare. Ok, take that as a premise, we aren't using wealth to decide allocation questions. So someone comes up and says they need more healthcare. We don't have the resources to deal with them. What is the criteria where they get told no vs someone else loses treatment? You're not allowed to say "well, we're assuming there is enough for both" because there are finite resources and infinite demands. We aren't dealing with food here where everyone can reasonably be fed. Everyone suffers from diseases and could use healthcare.

roenxi 6y ago

You're avoiding the question of "how do we choose who doesn't get access to a scarce resource" there though. It is all very well to say "we'll prioritise illnesses that kill people", but pretty much every death can be traced back to an illness. Even the ageing process could reasonably be defined as an illness, it probably will be one day if the world hasn't gotten there already. That leaves the unlimited nature of healthcare as an open problem. We all die, and arguably anything other than an accident death is people dying sick. > Then, you (as a society) ... define what "adequate" means based on your resources. Your country, and the US if if isn't your country, has already done that. The political process asked that question with Obamacare, for example. That is pretty recent accounting of what resources are available and what the people thought they could do with them. And you've not grappled with the key question - we aren't going to use wealth to decide who gets healthcare. Ok, take that as a premise, we aren't using wealth to decide allocation questions. So someone comes up and says they need more healthcare. We don't have the resources to deal with them. What is the criteria where they get told no vs someone else loses treatment? You're not allowed to say "well, we're assuming there is enough for both" because there are finite resources and infinite demands. We aren't dealing with food here where everyone can reasonably be fed. Everyone suffers from diseases and could use healthcare.