The Imperative of Rationing.

Brave Leonard M. Fleck, in an editorial for The Detroit News today, enters into a discussion that few wish to engage as health care reform occupies our national attention: the need for rationing. (Look for my article at AlterNet.org on the subject in coming days.)

Fleck does the math:

We spent $2.4 trillion on health care in the United States in 2008, about 17 percent of gross domestic product or national output, and projections call for that rising to $4.4 trillion in 2018, or 20.5 percent of likely GDP. A torrent of expensive new medical technologies drives costs upward.

As we discuss health reform, Americans ought to be able to talk to one another about excessively costly medical care yielding too little real benefit.

and rightly concludes:

Many Americans assert that human life is priceless (and rationing is morally objectionable), yet some criticize health reform, especially if it requires raising taxes. If the need for health care rationing is inescapable, then the real moral challenge is to determine how rationing can be done fairly and openly.

I agree. And I would clarify: We are the richest country in the world. The amount we spend on defense alone would ameliorate our health care cost concerns somewhat; but rationing is unavoidable and currently widely practiced without standard by insurance and medical companies. We now ration by class. Making how we ration more egalitarian is essential to a just and healthy society. Rationing must be discussed as a necessary, democratic and beneficial aspect of health care reform.