The Word They Dare Not Speak (Update)

No, it’s not one of George Carlin’s. The word is “rationing.”

At the core of the debates over healthcare in the United States, those who argue for some version of a national health care scheme, while promising all sorts of illusory cost advantages, are really pushing rationing of health care.

Britain’s National Health Service, according to a survey of readers of Doctor magazine, is increasingly relying upon rationing.

Rationing of NHS treatments is becoming more widespread, a survey of GPs and hospital doctors suggests.

Doctor magazine asked readers about rationing. Of 653 answering questions on consequences, 107 - 16% - said patients had died early as a result.

More than half - 349 - said patients had suffered as a result. This compared with one in five in a similar survey conducted nine years ago….

Dr Michael Dixon, chairman of the NHS Alliance, which represents NHS trusts, added: "Rationing is the great unspoken reality.

"The only people who refuse to mention the 'r-word' are the media and the politicians, who continue to want to promise everything for everyone in order to win elections."

It’s much the same on this side of the Atlantic. Has anyone heard any politician lay out the facts that we have a choice between widely getting the best of medical care, which costs plenty and will continue to, or instead rationing care?

The U.S.’s Kaiser Foundation published a report on health care costs last August, that deserves much wider distribution and discussion.

U.S. health costs are high and rising due to the U.S. being wealthier than other countries, which leads to higher consumption and to increased costly technological advances, our population is aging, insurance coverage has increased dramatically over the past 40-years, and Americans have less personal stake in healthcare costs as their share of out-of-pocket costs has declined from 40% in 1970 to 15% in 2005.

If no one making promises dare speak the word, it won’t make the dire realities of rationing go away.

UPDATE: USEFUL DISTINCTIONS
Don Luskin, SmartMoney columnist, economics blogger extraodinairre at Conspiracy To Keep You Poor And Stupid, initiator of yours truly into blogging, and valued corrector of my and others’ loose language, just emailed me this comment:

Actually, these schemes promise GOVERNMENT RATIONING as opposed to MARKET or PRICE RATIONING.

All scarce things, that is, anything of value, is rationed somehow. It’s just a question of how.

The advocates of nationalized health care want it rationed by bureaucratic fiat. Free-market people want it rationed by price.

But lest this make it seem as though the two positions are equal, consider that in the former doctors are slaves and in the latter they are merchants.

I replied,

Correct distinction.
With one further: Doctors aren't just merchants, but also experts, and they're face-to-face with the patient. Bureaucrats are neither.