Knowledge is Evil

That appears to be the new conservative slogan. As I mentioned a few days ago, the economic stimulus act includes money for comparative effectiveness research -- figuring out which treatments work best, and at what cost. I also mentioned that, to the loyal opposition, learning this information is the line of march to tyranny. WaPo's Steven Pearlstein, who is not exactly Vladimir Illyich Ulyanov, follows the bouncing meme through the echo chamber from the Washington Times to Betsy McCaughey to Matt Drudge to Rush Limpbag to the WSJ.

It seems that if we actually know that one procedure or drug works better than another, or that it costs a million dollars to get a small increment of benefit, the government will deprive us of our God given right to choose the worse option, or to misallocate our resources and get less for our money. The term for this particular form of totalitarian oppression is "rationing."

Of course, the real force behind this ostensibly principled, ideological stand is the drug and medical device industry, that wants to keep selling us its most expensive products whether or not they work, or work any better than the cheap ones. But as ideology, it is probably more idiotic than most of what conservatives "think." We currently ration health care by giving it to some people and not to others. Poor people and old people, oddly enough, can have the most expensive treatments, for the most part with little restriction. Medicare currently has some standards for what it will pay for, but they are based on whether a treatment is considered experimental, not on its cost effectiveness.

The taxpayers subsidize this privilege, and you might think that would upset the Loyal Opposition,but apparently it does not. Nor are they upset by the coverage limits many middle class people face who are lucky enough to have insurance, that already deprive them of some care based solely on price, without any consideration of value. It is obvious that there is no rationality behind the demonization of rationing, it's just yelling and screaming unencumbered, as Click and Clack would have it, by the thought process.

Here's a simple thought process. We live in a world of scarcity. The bounty we enjoy is not infinite. If we spend a million dollars to extend a sick person's life by one month, that is a million dollars we do not have with which to do something else -- perhaps, for example, prevent a thousand people from getting sick in the first place, or cure them early and easily. If we are able to properly understand that choice, then and only then can we make it.

Will that make us less free? Only if you equate ignorance with freedom. And it is true -- if you are ignorant, you do not need to concern yourself with difficult choices, and you do not have to know what you are giving up. You are free to believe in falsehoods. And that is indeed the essential ideology of conservatism.