Why we must ration health care

A very convincing article by Peter Singer describing the need for health care rationing, although “rationing” is a term which should probably be avoided in debate situations, for obvious reasons.

Essentially, we are already rationing health care by way of cost, and the objections that life has no set value, while true in some ways, are not good policy guides. After all, the million spent to extend one person’s life a year may have extended ten people’s lives by ten years each, if only the money was better spent.

He also gets into the definition of the Quality Adjusted Life Year, or QALY, a unit (life extended by one year, adjusted for quality of said life) for evaluating the efficiency of treatments. At some point, he says (and rightly, I believe), we have to say we are willing to pay no more than X for a QALY, otherwise we end up with… well, the system we’ve got, where costs are astronomical, while expectations and outcomes are no better than countries which spend a fraction as much.

This is going to be a major talking point in the coming years, I’m sure, because if health care really changes, it’s going to need to take some of this into account.

A commenter at Metafilter does bring up a good point, though:
“Regardless of how effective government-run health care might be, it’s not for our society. It’s for societies that pay for things.”