Sunday, August 16, 2009

Government Death Panels and Dear Ole Grannny

Where is there talk about goverment death panels in the recent healthcare bill? As far as I can tell it is nowhere to be found.

Does this mean that because it is not in the current bill in sect. x.y.z there won't be death panels in which government bureaucrats decide whether or not to "pull the plug" on Grandma? No. The problem is that in the long run the cost of providing healthcare will increase dramatically as more and more migrate to a "free" or lower priced piblic healthcare option, and business will as I've outlined in detail in previous posts. As costs increase and run up against a predetermined budget constraint which limits how much more can be spent, bureaucrats will need to decide how they deem it best to allocate scarce resources. Don't worry because the new 150,000 government bureaucrats the Federal government needs to hire to oversee it will do their best.

As these bureaucrats or a national health board or something like that meet they will need to provide guidelines as to what constitutes cost effective treatment. If they have a system with a limited number of doctors and nurse practitioners and a caseload that is more than they can handle, invariably a choice needs to be made given the immediate situation. If this means we have at any given point in time, come say 2022, and there are 8,000 kids under the age of 18 and 11,000 Grandmas in need of immediate care, the kids will get likely get the treatment. Grandma may die. These actions and the subsequent result is probably why some critics are calling it a death panel.

It may be very reasonable in light of the situation from society's standpoint to treat the kids and not Granny. However, the better way is to expand the constraint and not put authorities in the position of having to make such a decision. We should encourage more doctors, improve incentives via having people pay more for what they use, make patients more accountable for their choices, and incentivize industry and especially doctors to integrate technology to better run their practices. Oh, and we need desparately to do away with lawsuits so that doctors don't prescribe treatment and make referrals solely for lawsuit avoidance reasons, as they do in droves right now. To argue that a government public option will achieve these objections and at lower cost is truly laughable and actually a bit embarrasing.

So, yes it is likely that getting the government into healthcare will at some point require death panels. I know it is not explicitly in the bill. The purpose of analysis and an analytical mind though is to draw connections. Any sheep can read something as though its a technical manual on how to setup a stereo. As the President likes to say "I am willing to have a serious discussion" as he trivializes his opposition. So, yes, let's be serious and start thinking about the future consequences of our actions today.

No comments: