George Rebane

Just a quick one for those for whom the new Chief Rationer made sense with his statement that “The decision is not whether or not we will ration care. The decision will be whether we ration care with our eyes open.”  Dr Berwick’s contention that we already ration healthcare is calculated to impress the light thinkers in the land.

The notion of rationing is a subclass of actions known as allocation.  Something can be allocated to recipients in several ways. But the two dominant ways are by rationing and through the open market.  Rationing is determined by political favoritism smoke-screened by various measures of social utility.  (I can guarantee you that your utility is not the same as that of the politicians and bureaucrats in Washington.)  Kings and other autocrats have always rationed to curry favor from certain classes who were in position to guarantee/promote the longevity and material welfare of the ruler(s).

Open markets allocate resources through the powerful mechanism of price.  The price of a service or good efficiently communicates relative value delivered by competing suppliers, bringing about a rapid equilibrium between supply and demand that favors both consumers and efficient suppliers.

Rationing inherently gives rise to shortages of what is rationed (empty shelves, long lines, black markets, police state enforcement).  Open markets supply all that current human knowledge can provide.  And if that supply is meager, its attendant higher price invites in the competitor and entrepreneur to expand the market with a better and cheaper product.

Power-bent progressives highlight the failure of free markets to affordably supply their favored classes.  But they do that by first mangling the markets through government diktat, and then point to the capitalists who have appropriately gamed the mangled markets that typically feature reduced competition, excessive regulations, and added costs (taxes, fees, …).  The light thinkers then fall for the subsequent collectivist demagoguery highlighting the ‘failure of free markets’ to solve our social problems.

Allocation by free markets and the mechanism of price have always served a free people, giving us a quality of life that is the envy of the world.  Today big government has a head start on us, but please don’t let the next socialist or government co-opted corporation woo you into confusing rationing with the free market allocation of goods.  This battle for our minds is in full swing.