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View Diary: ACA's narrow networks allow insurance companies to gouge public, doctors (97 comments)

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  •  money doesn't need to be rationed (3+ / 0-)
    Recommended by:
    gooderservice, Chi, Pi Li

    A government sovereign in its own currency can print whatever amount of money it needs to.

    Doctors and health care professionals need to be rationed, medicines and technology need to be rationed. Those are real resources, they are finite, and they have to be managed carefully so that they aren't squandered and are directed with maximum effect.

    But money is not a resource, it is just a way of keeping score. You can't run out.

    You don't need to "control spending" as such under a single-payer program. You might have to control costs--maybe it's not desirable for other reasons to allow companies to charge too-high a price for medicines and technology--but not because you need to limit spending.

    The real question is not whether it's too expensive to approve a certain procedure for Grandma, that's a red herring. The question is whether it's a smart use of limited resources (medicine, tech, doctors, nurses, hospital beds) that could go to other patients who might have a better chance of making it if those resources were used to treat them.

    Antibiotic resistance is a classic dilemma of this type. Every use of an antibiotic on one patient decreases its effectiveness for other patients because it increases the chance of antibiotic-resistant bacteria.

    So when you're faced with a very sick older patient who probably won't live too much longer even if you cure him/her, should you use the powerful antibiotic and risk creating a strain of antibiotic-resistant bacteria that could kill or sicken many younger patients with a longer life expectancy?

    These are very hard decisions, much harder than trying to limit spending. Harder to quantify what the risks are and how care should be rationed. To weigh the abstract possibility of future patients dying from an antibiotic-resistant germ against the immediate and concrete certainty of a dying patient now is very difficult.

    "In America, the law is king." --Thomas Paine

    by limpidglass on Sun Nov 24, 2013 at 04:09:52 PM PST

    [ Parent ]

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