[p2p-research] Rhetoric of Rationing Health Care Overlooks Reality - NYTimes.com

[Paul D. Fernhout]

http://www.nytimes.com/2009/06/17/business/economy/17leonhardt.html?_r=2&hp
"""
The r-word has become a rejoinder to anyone who says that this country must 
reduce its runaway health spending, especially anyone who favors cutting 
back on treatments that don’t have scientific evidence behind them. You can 
expect to hear a lot more about rationing as health care becomes the 
dominant issue in Washington this summer. Today, I want to try to explain 
why the case against rationing isn’t really a substantive argument. It’s a 
clever set of buzzwords that tries to hide the fact that societies must make 
choices.
"""

In the long term I don't think we will need to ration what we now consider 
most of the basics on an individual level (food, water, healthcare, toys, 
shelter, communications, transport, etc.; see Voyage from Yesteryear by 
James P. Hogan for an example), but currently we are doing that, and this 
article talks about how to do it better in the USA for healthcare.

In general, Iain banks said: "Money is a sign of poverty". One meaning of 
that is, if you have to ration day-to-day things for individuals, you don't 
have enough of them because your technology is not very good. So, if you 
have 3D printers that can print solar panels and more 3D printers just from 
inputs of dirt, water, and air, and previously printed things (recycling) 
then why would you need money very much day-to-day? Maybe for allocating 
land you might need some sort of rationing, but that is such a different 
thing from the day-to-day rationing we see in our current system revolving 
around spending money at stores.

I've repeatedly called dollars "ration units" to help make clear that our 
current economic system is more about rationing than optimum wealth creation.

Anyway, one deep issue of p2p is really, how would p2p change the types of 
rationing we do in our society? And how would p2p change how we do each type 
of rationing?

I've been looking more at the "Venus Project" and I think this is an issue 
it glosses over (from what I have seen so far). Jacque Fresco and Roxanne 
Meadows may intuitively understand that with good engineering rationing the 
basics won't be a big deal anymore. They reference "cybernetics" as a way to 
approach this, and I agree that's a good idea (like Cybersyn) as long as you 
have something of a command economy or even market economy (gift economies 
and subsistence economies may work differently with less formal planning). 
But, the details still have to be worked out (unless they have in the Venus 
Project and I have just not found them yet as I continue to learn about that):
   http://en.wikipedia.org/wiki/The_Venus_Project
   http://en.wikipedia.org/wiki/Resource-based_economy


Even in a "resource base" economy", the society collectively makes decisions 
about how to invest and deploy and distribute resources. Now, those 
rationing decisions may be a lot easier the more resources we have, 
especially once humans can easily live in seasteads and space habitats built 
from local materials. But, even then, they will still be made. So, a big 
question is, how to make them well? And well for whom? (Who pays the costs 
and who gets the benefits?) And how do we get there from here?

--Paul Fernhout
http://www.pdfernhout.net/
(I walked 0.24 miles while writing this as part of my health care plan. :-)