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One the primary goals of any - and indeed every - medical system is to ration resources. Which is to say to privilege access to medicine. When we talk about med
by Kalium 3y ago
One the primary goals of any - and indeed every - medical system is to ration resources. Which is to say to privilege access to medicine. When we talk about medical care access, we tend to talk around this, but it's a needed part of any system. Any system that doesn't do this quickly learns, institutionally, that without some limiting mechanisms in place the system will be overwhelmed and its resources exhausted.
Obviously some approaches and systems work better than others and are more tolerant to some kinds of faults. Unfortunately, none of this gets away from the absurd, insulting, and grotesque reality that care has to rationed somehow.
- throwaway118899 3y ago> One the primary goals of any - and indeed every - medical system is to ration resources. We can fix this. Essentially, every smoker, every alcoholic, and every obese human immediately goes to the back of the line. No need for this convoluted bullshit of a system.
- roenxi 3y agoFirstly, that is still a convoluted bullshit system for rationing healthcare. Logically you'd have to assign some sort of worthiness score to every activity that matters then track everyone to figure out their score and stop them lying to get to the front of the queue. Even if you literally only mean these 3 things, you'd have to track smoking and alcohol consumption. I doubt that'd be enough to effectively ration healthcare though, since the resource demand is practically infinite. Secondly, you're inviting some really complex moral and political arguments. There have been worse ideas than linking healthcare to a political assessment of lifestyle, but I suspect it'd be up there in the same orbit as communism, genocide and slavery. It is hard to see it ending well once the politicians start to disagree on the healthiness of people's lifestyles. I dunno, in some ghoulish sense it might be the next logical thing for the US to try. Why stop at merely bad ideas?
- nradov 3y agoThe Affordable Care Act (Obamacare) does allow health plans to charge higher premiums to smokers. Implementation varies by state. I'm sure that a lot of plan members just lie to avoid the surcharge. https://www.kff.org/faqs/faqs-health-insurance-marketplace-and-the-aca/can-i-be-charged-higher-premiums-in-the-marketplace-if-i-smoke/ https://www.kff.org/faqs/faqs-health-insurance-marketplace-a...
- roenxi 3y agoThat doesn't put smokers at the back of any queues. They still get resources roughly in line with the amount of money that they have.
- DinaCoder99 3y agoThe absurdity of people defending possibly the worst system of rationing healthcare on the planet will never grow stale. I suppose straight up denying healthcare based on class would be worse. But such a system would actually afford its customers the dignity of honesty.
- Kalium 3y agoI'm sorry, I can see I have been unclear. I am in no way defending the worst system of rationing healthcare on the planet. It's awful, horribly, abominable, and must be changed to include some basic fucking humanity. I'm saying that rationing is inevitable and our thinking about health care systems needs to account for that.
- DinaCoder99 3y ago> I'm saying that rationing is inevitable and our thinking about health care systems needs to account for that. I understand there are utopian arguments for healthcare, but where is the demand to respond to them? I am in no way condemning the individual response to this I'm just earnestly curious where this impulse comes from.
- TeMPOraL 3y agoBecause, arguably, vast majority of people - in other words, public opinion, or vast majority of voters - don't understand that healthcare has to ration scarce resources too. Healthcare being a right is a nice, feel-good slogan, but does little to address resource scarcity or system inefficiency.
- swed420 3y agoDismissing basic, reasonable expectations as "feel good slogans" is a smarmy tactic to distract from wealth hoarding. The sky is the limit with what humans can do, but under late stage capitalism, it boils down to the preferences of those who control the system, and nothing more. https://nymag.com/intelligencer/2022/03/how-asset-managers-have-upended-how-modern-capitalism-works.html https://nymag.com/intelligencer/2022/03/how-asset-managers-h...
- tacocataco 3y agoI guess increasing supply isn't profitable enough compared to artificial scarcity.
- Kalium 3y agoEvery healthcare system I've ever encountered, read about, or heard about has some kind of rationing. This is apparently independent of questions of profit or non-profit, private or public. Socialized, not-profit-driven healthcare systems also have to ration resources somehow.
- Blahah 3y agoIt's certainly a constraint of any medical system but not a goal, primary or otherwise. The goal of socialised medicine is to provide medical care equitably to everyone who needs it - to assign that as a right. Care only has to be rationed to the extent that resources are constrained below what is required to meet the need. And all of that is orthogonal to a system like that in the US, where care is a luxury not a right.
- nradov 3y agoHow do you define "need"? We certainly should do better at improving access to affordable care and eliminating inefficiencies. But need for healthcare is essentially infinite for patients with serious chronic conditions or near end of life. And as the population becomes older and more obese that will be an increasingly larger share. We just don't have the resources to pay for everything regardless of where the bill goes. Care rationing in most developed countries will only get stricter.