Do not pass GO. Do not collect heart transplant.
The complexity of allocating health care morally
ABC News reports that the morbidly obese are unlikely to receive heart transplants because their chances of recovery are so slim. Some transplant centers purportedly have a Body Mass Index cutoff of 35.
Although nobody died in the making of the ABC story, the same cannot be said of this horrific anecdote from Britain, in which a premature baby was unattended to for being born two days too early. Elsewhere in the world, a 69-year old Japanese man who was hurt in a traffic accident was turned away from 14 hospitals before he died. In slightly funnier twist, a Swedish man fed up with waiting sewed up his own leg (successfully) and was charged for the unlicensed use of medical instruments.
Healthcare horror stories seem to crop up everywhere regardless of the kind of system that prevails. The American healthcare system is a mixed-public private system, as are those of Germany, France, Switzerland, and the Netherlands. Sweden, the UK, and Canada are single-payer government-run systems. No examples of a pure free-market healthcare system exist anywhere.
Under a pure free-market healthcare system, care would simply be rationed on the basis of the ability to pay and perhaps the charity of doctors. Supply would meet demand, end of story (nothing like this has ever existed for reasons that are beyond the scope of this post). This strikes most people as at least a little offensive –if a child’s parents cannot afford a life-saving procedure, should that be the end of the story? A pure free-market system would definitely have its share of horror stories too.
Since people generally think “no,” all countries involve the government in healthcare to some degree. But if people are to receive care on some criterion other than the ability to pay, then other rules will need to be devised because it is all but guaranteed that the demand for medical services will outstrip supply. The absolutist position that all people are to receive all necessary or helpful care is simply untenable.
Cost-benefit considerations will surely come to the fore. But the utilitarian mantra of the “greatest good for the greatest number” becomes problematic when we are no longer sure what “good” or even “number” means. Maximizing the “life years” of your patients may conflict with maximizing the total number of lives saved, and we haven’t yet resolved whether all lives or “life years” are equal. In addition, not all medicine is life-saving. Some, if not most, merely makes life more comfortable, which is why we cannot simply treat a healthcare system as one big triage center.
The perennial question of just desert takes on an exceptionally morbid tone wherever health is concerned. The “death panel” of scarcity will always exist, regardless of whether actual death panels do.
-Charles
Image by Flickr user ortizmj12 used under a Creative Commons Attribution License
Related posts:
- Should Congress pass an airline passengers’ bill of rights?
- Who lives and who dies?
- Healthcare is nice, but (morally) expensive
- More on healthcare and choice
- Subsidizing spiritual healing
ShareComments
Leave a Reply
