In a recent discussion about the no one should die because they can’t afford health care meme, I made the distinction in passing that markets allocate, only governments ration.  Responding, the person with whom I was discussing the matter on FB argued that “a free market also engages in rationing”.

I didn’t give this topic a thorough exposition at the time; consider this my penance, because it’s crucial that people understand the distinction.

Rationing vs. Allocation

Make no mistake about this: if the government mandates some form of health care (and I have every reason to suspect it will come down to this), rationing will prevail.

Allocation is the product of exchange: when those doing the demanding exchange value-for-value with those doing the supplying. You might not like the manner in which prices allocate goods and services, but if the price mechanism has no other virtue it is this: you don’t have to pay for it if you don’t want it.

Rationing on the other hand (especially in any venue mandated by politics), happens after you’ve paid in to the system. It happens when quantity demanded exceeds quantity supplied and all of the demand is backed up by a positive legal privilege; really an entitlement/welfare.

• It is “rationing” when a bureaucrat determines that your premature infant will not receive any care from the government health care monopoly and she dies two hours later.
• It is “rationing” when a bureaucrat determines that even though you’re dying of cancer and the Pharma company is willing to give you drugs for free, the state health care monopoly will not allow you to obtain them, or to have them administered.
• When the drug which offers you the best chance of survival is only offered privately (not covered under the government plan) and you are denied further government-provided health care because you dared to buy a drug which they refused to buy for you — this is “rationing”, not allocation.

Rationing is the inevitable result of policies which dictate: no matter how badly you want or need something, and no matter how much you’re willing to forsake in exchange, you are entitled only to a roll of the rationing-dice. Some people win, and some people lose, but they were all forced to pay.

Allocation by price, via the market is not perfect, and no honest defender of free markets would dare suggest that it is. But it preserves personal control, responsibility, and freedom; ideals to which no government rationing scheme could even hope to aspire.

“Smoke and mirrors” are the methods used by magicians, in order to keep the audience from recognizing their sleight of hand. It’s easier to convince people that your lovely assistant has vanished into thin air when they can’t see the trap door.

The big discussion this morning on r/Politics (and all over the morning network TV) is about a Republican congressman: Joe Wilson heckled Obama during his speech on health care. There is little to no discussion about the actual issues. Instead, this “Joe Wilson disrepsected the president” distraction becomes the topic du jour.

Once something is left to the political arena, the natural tendency is towards a reduction (and ultimately the removal) of any choices. Once the mechanism of politics has “chosen” one course of action in favor of all others, typically all other course of action are outlawed, taxed, or strangled with regulation. This will be as true of health care as it is for anything else.

In politics, it’s easier to cram controversial proposals down the public’s collective throats, when they’re distracted by bread, circuses, or nonsense. Former presidential candidate John McCain says they need to scrap the current health care proposal(s) and start over from a bi-partisan approach.  But bi-partisan is just a fancier way of saying mono-partisan; it is the removal of the last semblance of choice from the political arena.

I propose a non-partisan approach: Keep your blood-stained hands out of my life, out of my pockets. Keep them off my health care, my insurance, my business.

I posted my initial reaction to the no one should die because they can’t afford health care meme on Friday. Since then, 47% of search traffic to this blog was generated by some variant of the meme:

no one should die because they cannot afford health care and no one should go broke because they get sick. if you agree please post this as your status for the rest of the day.

I have to admit that the post was probably not my finest, it was hastily thrown together while I was waiting for the coffee to finish brewing before I ran off to work, but it was blogging as blogging’s meant to be, I suppose.

Prompted in part by a facebook discussion, but also by the tremendous amount of traffic that the post generated, I took some more time to think about the topic over the holiday weekend. The highlight was when I watched as a dyed-in-the-wool Republican and a dyed-in-the-wool Democrat duked it out on my facebook page, eventually the Democrat suggested that,

Objective studies rank the current health care system [in the U.S.] at around 24th in the world on such “soft” stats as infant mortality and life expectancy.

If, of course, by “objective” you mean “spin”. Needless to say I was thrilled to reference Warren Miller’s analyses of what the numbers really mean.

On life expectancy, the oft-cited data has not been normalized. Translating this from statistical sampling language to plain English, this means that we need to control for differences in the populations being sampled (ok, I admit that wasn’t much of a “translation”).

As for the bogus infant mortality figures, Meyer notes that in the U.S., we try to save even extremely premature infants (many of whom die anyways) whereas in other countries, they are callously written off as “unsalvageable” and counted as stillborn. In English, this means that other countries intentionally under-report live births, which skews the survival rate.  I would like to point out now (as I didn’t at the time) that the bureaucracies in charge of determining that no infant born weighing less than 500g will be declared “unsalvageable” and counted as stillborn is a death panel.  Even though they are not euthanizing patients, the very act of setting rules for who is allowed to receive care necessarily relegates the others to die.

As you might’ve guessed, there was no further argument.