realism vs. utopia on health care availability

Michael Tanner, from Cato, in USN&WR, with a helpful piece...

No one can fail to be moved by heartbreaking stories of people suffering and unable to get healthcare they want or need. But compassion is a sentiment, not a policy.

We tend to talk about healthcare in the philosophically abstract. "Is healthcare a right or a privilege?" goes the refrain. In reality, it is neither.

Healthcare is a commodity -- and a finite one at that....

The real debate, therefore, is not about whether we should ration care but about who should ration it. Currently, that decision is often made by insurance companies or other third-party payers. Obama and congressional Democrats want to shift that decision-making power to the federal government....Free-market healthcare reformers, on the other hand, want to shift more of the decisions (and therefore the financial responsibility) back to the individual.

People should have the absolute right to spend their own money on whatever they want, including buying as much healthcare as they want. And, if they are spending their own money, they will make their own rationing decisions based on price and value....

Of course, as a compassionate society, we may choose to help others pay for some care. That's a worthwhile debate to have. But our resources are not unlimited. Choices will have to be made. And, therefore, the real question should be: Who will make those choices?...