Health Care is a Right

The U.S. is suffering from a dysfunctional health care system that does not provide basic health services to many but still manages to consume more money than anyplace else on earth.

How do we decide how much to spend and how do we spend it?

I think that this is the core issue when people propose 'universal health care' or 'health care as a right'. People worry about public funding of cosmetic surgery, genomic based treatments, lifestyle diseases, etc.

The answer is simple; and it is complex.
First, the simple answer... 'as much health care as we can afford'.

Q: How much is that? A: X dollars
Q: But that's rationing! A: Yes
Q: That's communistic, socialistic, immoral, etc.!
A: Our current system is rationing based on ability to pay, not individual need and not on the value of the treatment. Our country currently spends 2x to 3x as much per person as other developed countries, all of whom provide better care and as a result have better basic health indicators. Even Cuba has equal or better health indicators than the U.S.
The 'free market' for health care in the U.S. is very successful at producing spectacular profits for everyone involved and a dismal failure at providing goods and services that improve health. This is a profound market failure.
Q: How do we ration?
A: We need adult supervision. We need regulation. We need the government deciding which services are useful and beneficial and cost efficient.

I know this is an extremely unpopular message and I expect that everyone who is making money in the current system will attack it and patients will also attack it because they will (wrongly) perceive that they won't get needed services. They will get needed services. They won't get every unproven test and treatment. If they want to spend their discretionary income on unnecessary tests and unproven treatments and concierge medical care, that's fine. Just don't expect the taxpayer to fund it.

Welcome to the real world. This is the way the rest of the world works. The party on Wall street is over. It is time to end the party that we call 'U.S. Health Care'. It too is a house of cards that is generating obscene profits while providing services of dubious value.