A Stitch in Haste

To review: All scarce goods and services must be rationed, if not by a market mechanism then by politicians and bureaucrats. But the rationing will take place. "Universal health care" is an economic and metaphysical impossibility.

Is there any better example of this axiom than organ transplantation: (WSJ - $)

The nation's organ-transplant network is preparing a major change in how it rations scarce kidneys that would favor young patients over old in an effort to wring more life out of donated organs.
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Today, a donated kidney generally goes to the person who has been waiting longest in the region in which it becomes available, with exceptions made for certain medical factors. A kidney from a 25-year-old donor could be transplanted into a 75-year-old, who is likely to die years before the kidney would have stopped working.
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The concept is gaining traction among transplant doctors but creating anxiety for some patients and surgeons who worry the new system won't be fair to all. "Is it correct or permissible for the system to say the five or six more years of life that a 60-year-old is going to get are less valuable, less important than the 15 more years of life the 30-year-old is going to get?" asked Richard Freeman, a transplant surgeon at Tufts-New England Medical Center in Boston.

Good question. So good that honest economists (and all libertarians) recognize that it's impossible to answer. Interpersonal utility comparisons are simply not possible. Which in turn means that "social welfare" is a fiction and utilitarianism is a fraud.

I'm not taking sides in the debate between awarding kidneys based on age versus wait times. I'd prefer a market-based system — which, despite the irrational protestations of some that buying and selling organs is somehow "demeaning," would vastly increase the supply of organs available to everyone.

My point here is simply that a "right to health care" ought to include a "right to a kidney." If such a right is impossible (and it is), then so too is "universal health care." Stated differently, "socialized medicine" and "universal health care" are not synonymous. It is not "fear mongering" to use the former term rather than the latter — it is simple intellectual honesty.

All health care — including kidneys — must be rationed. Socialized medicine cannot and will not change that. It will only change the rationing scheme — for the worse.