Healthcare is an almost unique combination: once a technology is invented, it must be used. The physician has no morally acceptable — or legally tenable — ground upon which to say no. So, every available technology must be offered to every patient.
There was a time when those who could not afford a treatment probably would not get it, and it was within the mainstream to think this was ok. Not everyone thought it was ok, and I’m not saying it was ok — it was just one of the hard facts of life. Today, it is no longer tenable to think that people will suffer or die because they cannot afford treatments. What once was a hard fact is now a moral outrage.
It doesn’t matter whether you agree with this or not. The sea has shifted in the recent decades, and it will never shift back.
Add these two forces up: 1. Whatever treatments are invented, must be used 2. No-one can be denied care because of money. This confluence creates a tsunami of costs. We call this our health-care cost crisis, but it is more precisely a historically unprecedented combination of forces. I think there is no parallel for a technology that carries a moral imperative (as opposed to a utilitarian option) to be used in all cases.
There is no way, then, to avoid the nationalization of health care. (I write this as a small-government conservative). The math does not add up to anything other than nationalization. I write this as a healthcare administrator who has worked all my life in the industry: all Western health care will be taken over by governments. There is no other “solution” to the math.
The real crisis will come after nationalization, when the math will not have changed, and the care will have to be rationed by bureaucrats, and — far, far worse — the state will not be able to avoid controlling all activities that are likely to impact your health.
It is not possible for the State to fund something and not control it. It is simply, politically, not a possibility. So let me say that again: no matter what the intentions of this generation of policymakers is, the State will not be able to avoid controlling all activities likely to impact your health.