On the front page of the business section in today’s New York Times, David Leonhardt builds his column around a propaganda technique that is really a baroque twist to an old-fashioned rhetorical device. That is, unless you think Leonhardt really doesn’t know the meaning of a simple word we all use.
Leonhardt wants to show that rationing of medical care can be a good thing, but the example around which his article is built, Richmond, Virginia, is not about rationing, even though he says it is. What Richmond, Virginia did was to cut the supply of hospital beds. Leonhardt is either a) obtuse or b) manipulative (I select “b”) in calling the decline in beds an example of rationing, when in fact there has been no limiting of access to hospital beds in Richmond.
Here’s exactly what David the Lionhearted says:
“Since 1996, the Richmond area has lost more than 600 of its hospital beds, mostly because of state regulations on capacity. Several hospitals have closed, and others have shrunk. In 1996, the region had 4.8 hospital beds for every 1,000 residents. Today, it has about three. Hospital care has been, in a word, rationed.”
Later Leonhardt demonstrates that care has not suffered in Richmond.
Now here are the definitions of “to ration” that my favorite online resource, Merriam-Webster’s Unabridged dictionary, gives:
“1 : to supply with rations : put on rations 2 a : to distribute as rations : allot in rations b : to distribute or divide (as commodities in short supply) in an equitable manner or so as to achieve a particular object (as maximum production of particular items) — compare DIRECT CONTROL c : to use or indulge in sparingly synonym see APPORTION”
There’s nothing in there about cutting supply, only about cutting access. Richmond had an oversupply, which it reduced, with no impact on the health care of its residents. We have a lot to learn from the positive steps Richmond took to reduce oversupply, but it teaches us nothing at all about rationing.
My guess is that David Leonhardt believes that one day we may have to resort to real rationing, which means limiting access to health care. So he tries to sneak one by us by labeling something as rationing that everyone will think is a great thing but unfortunately is not rationing.
The old rhetorical trick is to call a negative thing by a positive name to make the thing sound better. The baroque twist that David the Lionhearted makes is to call a positive thing by a negative name to make the name you call it sound better.