Writing in Public Discourse today, Yuval Levin argues that it is both possible and necessary to curb entitlement spending and broaden the provision of healthcare in a manner that respects the equality and dignity of all. His piece covers a good deal of ground, but one of its most interesting claims is that it is better to leave rationing (the fraught death panel-type decisions) in the hands of private companies rather than in those of a public body:
In a competitive health sector, some rationing decisions would be made by insurance companies, not by families, especially in cases where the familys means are limited. Having insurers make such decisions is marginally better than assigning them to a panel of distant public officialssince the insurers are more directly answerable to their consumers and more directly in touch with the particular physician on the spotbut only marginally so.
Yuval goes on to argue that corporate actors can allocate health resources in a manner that is not only more efficient but also more humane. This, he suggests, is because the market begins with a deep assumption of equality:
It is not by coincidence that the fiscal and moral concerns that define the health-care debate are both best (if always imperfectly) addressed by market-based solutions. For all the tension between market capitalism and traditional morality, both begin from a belief in the essential equality of all and the profound freedom and dignity of the human individual. Social and fiscal conservatives hang togetherand jointly oppose the technocratic collectivism of the leftfor far more than pragmatic reasons.
You can read the rest here .