Who Decides What

This article appeared in the Washington Times on September 2, 2009.

Do you think pedophiles should be given Viagra at taxpayers' expense? Despite what appears to be an absurd question, that is exactly what occurred in Britain under their National Health Service (NHS).

Reports surfaced last week that a pedophile who had abused an 11-year-old girl had been spared jail, yet was continuing to receive Viagra, courtesy of the British taxpayer. On Aug. 23, the London Sunday Times reported that the NHS has spent more than $2.5 million during the "past five years on sex-change operations for transsexuals."Earlier this year, it was revealed that the NHS paid $6,000 for breast implants for a 17-year-old girl "because she was jealous of school pals' bigger busts," which caused her to be moody. Susie Squire of the British Taxpayers Alliance, reacting to these outrages said, "The NHS is struggling to provide basic and lifesaving surgery. Cancer drugs should always come above [breast enhancement]."

The misuse of taxpayer money that Ms. Squire and her colleagues have identified is a direct result of British government officials having the power to decide what medical procedures will and will not be allowed under the NHS.

If the United States creates a government-run health system, either as a monopoly single-payer system like Canada's or one that allows people to acquire medical care outside the government's system (provided they pay for both the government system and whatever private alternative they select), it is a safe bet the same types of abuses and problems that plague Britain and Canada will occur.

The reason is simple: There will only be limited funds available for the government-run health care system, and thus individuals employed by the government will decide who gets what and when. Some of the decisions will be wise; others will be foolish, wasteful, or just plain daffy -- because humans who spend other people's money don't tend to be all that careful.

Unlike most other goods, there is an insatiable demand for health care, particularly as people age. Any government trying to provide "free" health care for all its citizens for whatever they deemed to be a health problem would soon be bankrupt. To avoid bankruptcy, all governments ration health care -- by price, queuing or by form of treatment. Many members of Congress and the president -- after first admitting it -- now deny some form of rationing will be necessary. President Obama earlier suggested limiting forms of treatment, particularly to the elderly -- as is done under Medicare.

Medicare now rations by price, limiting the amount doctors and hospitals can receive for various services; hence, many doctors have dropped out of Medicare -- and for good reason. Medicare also rations by what treatments are covered, so Medicare recipients are forced to buy various supplementary policies for what is not covered.

If a system like Medicare is forced on the rest of the population, citizens will quickly find that their choices are limited and they will have to pay more and more for supplementary insurances because, like Medicare, costs will grow faster than income -- and to limit those costs, government will impose more and more treatment limitations, both by age and what is covered.

Proponents of a government takeover argue that private insurance companies also limit what they will pay for and the amounts they will pay, but unlike the government they do not restrict individuals from paying for noncovered services. People also have the right to change insurance companies if they are not satisfied with the quality of the service or which conditions are covered.

Many of the existing problems with private insurance are due to political meddling, which forces insurance companies to cover conditions that the consumer may not desire, thus forcing up costs without a commensurate benefit.

As a free individual, you should have the right to decide what kind of medical treatment and what kind of medical insurance you should have. If you want a nose job , it is your business if you are willing to pay for it.

Why should a government bureaucrat have the right to tell you what anti-cancer drugs you can and cannot have? How old is too old to have a hip replacement?

In fact, we already ration our own health care. We make those decisions based on how long the treatment will take, how much pain it will cause or alleviate, how life threatening it is, and how much it will cost for that perfect smile. Cosmetic dental work is much more important for most 25-year-old women than it is for most 90-year-old men - but each should have the freedom to choose.

Some people would prefer not to undergo a very expensive medical treatment to extend their lives another six months, because they would prefer to leave the money to their children or favorite charity; others would choose differently.

Government-run health care and mandates, by both fiscal necessity and the need to treat everyone alike, take away personal choice. If you believe yourself to be an individual with your own preferences and needs, which may not be the same as everyone else's, then the quality of your life and freedoms will necessarily be diminished by government-dictated health decisions.