Dealing with shortages

In this hurly burly discussion of who ought to be picking up the bill for healthcare in our society, and by what process they ought to do so, we tend to forget one terribly crucial question: Can we afford it?

Common sense says we can’t. Just yesterday afternoon, for example, I heard about three folks from my own little church who needed costly medical attention. An infant’s inability to assimilate nourishment had reached something of a crisis. A teenager struggles with severe intestinal issues. A senior citizen had major surgery for colon cancer. I can only imagine the total cost of yesterday’s procedures. I know the families involved well enough to be confident none of them could just write a check for the bills that are sure to come.

Bottom line is: Who will ultimately sort all that out? What if there’s not enough to go around? What if we get to the end of the line, face the task of divvying up what resources are left, and find that either the infant, the teenager, or the senior citizen comes out on the short end of the stick?

For until we get a whole lot smarter than we are right now, we’re always going to be running short of healthcare somewhere, on some front. The law of scarcity is inexorably at work in the field of healthcare. Only a few people out of a thousand have the brains and the gifts to be great surgeons—which leads us to value them highly and typically to pay them well. Such shortages—among doctors and the structures that support them—are reflected everywhere. You see them vividly in your having to make doctors’ appointments several weeks in advance, and then to sit in the waiting room after keeping your appointment. If there were no shortages, you could walk right in as you do at Walmart.

Sorting out and resolving such shortages is perhaps one of the main assignments we lay on our healthcare systems. Traditionally, we’ve let that happen several ways.

Dominant among those tools is the largely invisible “market system,” where the ability to pay determines who gets served, and how soon. It may seem crass, but it only stands to reason that a very wealthy person enjoys the option of going to the head of the line—in either the waiting room, the operating room, or anywhere else in the system. If the infant I mentioned and the teenager and the senior citizen were all from wealthy families, the issues of ranking their care would be moot.

Health insurance is a second tool we’ve developed to sort out and resolve shortages. In a way, health insurance is simply a means to encourage us all—voluntarily—to save up for the medically related issues that are almost sure routinely to confront us in the future—or for the gigantic issues that we had no way of predicting. Health insurance is, in one sense, an extension of the market system in that it allows for significant ability to select the package that best fits your individual needs.

A third major tool intended to sort out and resolve shortages is simply to turn the assignment over to a supposedly strong, able, and fair entity like your government. That, of course, is the ultimate goal of President Barack Obama and his administration. In the course of the current fiasco, it may even be his short-term goal as he scrambles to find any tools possible to rescue his ill-fated Obamacare program. But all three adjectives—strong, able, and fair—have now in short fashion become suspect as applicable to our federal government. Through his own administrative misadventures, Obama’s whole idea of a “single payer” source of addressing shortages has become both scary and toxic in ways his ideological opponents could scarcely have imagined.

Until we reach God’s perfected kingdom, shortages will characterize the whole field of healthcare. Our longing for good health, coupled with the great advances God has allowed in the treatment of illness, suggests the costs will continue to be high. But if the last few weeks have taught us anything at all, they’ve been a warning not to turn hard assignments like these over to Washington.

Email jbelz@wng.com