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The Right has developed a kind of shorthand language for talking about the future they fear more than any other, and the key word in that language is “rationing.” On any given news day, politicians, pundits, and media personalities who oppose climate protection, hate food assistance, and fear universal health care can be heard making the claim that if any serious steps are taken toward creating a fairer, healthier, more ecologically sound society, then we will be faced with rationing. And—on this point if on nothing else—they’re right.
But while that prospect is anything but appealing, many of us see much worse fates looming: a climate gone haywire maybe, or wholesale extinctions, or deadly pandemics. So those of us calling for bold action to stave off such catastrophes should drop the euphemisms and admit that the future we want could well entail rationing.
Or to be more clear, we’ll need new forms of rationing. Today, with the widening wealth gap, we divvy up resources all the time with no regard to fairness. Some of us are not even aware that anything’s wrong, while others see their consumption harshly limited by privation. It’s very true that fairer, explicit forms of rationing would not fit comfortably into today’s economy. But so what? They’ll be essential if we are someday to enjoy the kind of ecologically robust society that is envisioned in Earth Day celebrations.
That’s because creating such a society will mean cutting back deeply on our exploitation of fossil fuels and other resources. Otherwise, there’ll be an ecological cliff waiting not far ahead.
Evidence of that cliff is overwhelming. At least one-quarter of all plant growth and freshwater flow on Earth is captured and used every year by our species. In a high-profile paper published four years ago, a group of twenty-nine scientists from seven countries defined nine “planetary boundaries” within which humanity can “operate safely.” Their grim conclusion: levels of carbon dioxide, ozone, nitrogen, sea-organism loss, freshwater resources, soil erosion, species extinction, and industrial chemicals show that we have either already breached, or are on the way to breaching, all of the Earth’s critical boundaries.
Strong limits on resource consumption are required to pull us back within the safe zone, but that would be very likely to send prices of basic necessities sailing out of the reach of most families. Inflation controls would become essential, but that would unleash pent-up demand, which would outstrip the fixed supply. The result—as experiences of the 1970s, for example, have taught us—would be critical shortages, endless waiting lines, and social conflict.
Therefore, any serious ceiling on total resource consumption will bring on the need for fair-shares rationing. Green-growth enthusiasts don’t want to accept that. But hard experience, in peacetime as well as wartime, shows that our economy generates new resource-consuming technologies at a much faster rate than it does resource-conserving ones, while campaigns for voluntary restraint inevitably fizzle in the face of a one-two knockout punch: the economy’s built-in drive to expand and our vast rich-poor gap. In contrast, clearly defined resource limits backed up by rationing have proven to inspire a sense of common purpose and cooperation.
Among the many ideas for ensuring that economies conform to ecological reality, the boldest have featured rationing of greenhouse emissions. Since the 1990s, for example, activists and academics in the United Kingdom, and even some members of Parliament, have been advocating mandatory carbon rationing. Under such plans, each adult Briton would receive, free, an equal share of emissions credits each month. Then every fuel purchase or payment of a utility bill would require a debit from the household “carbon account.” At the gas pump, for example, this might mean swiping a ration card in the same way a customer would use a “loyalty card” today.
Eventually, though, circumstances may require more comprehensive systems, such as rationing of all goods and services based on their full ecological footprints. There’s even the idea of general, or expenditure, rationing—first conceived by World War II-era economists but never put into practice—which would place a monthly ceiling on how much money each household can spend.
It’s most often in the context of the U.S. health-care debate that the R-word shows up in the media. If the adversaries in that debate can agree on nothing else, they at least use the same definition of rationing: it’s something that will happen if the other side prevails.
But of course there’s no shortage of medical rationing going on right now. Uninsured heart patients are less likely to find treatment than are those with insurance; children lacking private insurance are 80 percent more likely to have trouble getting specialist care; and when receiving a diagnosis of breast cancer, uninsured patients are told three and a half times more often than are insured patients that their cancer has already metastasized.
In the medical world, rationing American-style means excluding patients. But if we must discriminate, it should be against drugs and procedures, not people.
Waste reduction, that ill-defined panacea, won’t be enough. Eliminate all ineffective or counterproductive treatments, and the medical world will still have to contend with a deluge of increasingly expensive technology, soaking into the economy year after year. Once a technology is declared beneficial, the industry is obliged to offer it, however small the expected improvement in quality or length of life. As a consequence, medicine will soon occupy an unhealthy one-fifth of the entire U.S. economy, on the way to one-third.
Daniel Callahan of the Garrison, NY, Hastings Center, a bioethics think-tank, has called for curtailment of medical research-for-profit. He contends that “when the research imperative acts as a moral bludgeon—turning a moral good into a moral obligation and then into a call to arms—to level other values in the name of reducing suffering, it goes too far.” To resist such supply-side bullying, Callahan has suggested that we “come to see health care as being like fire, police, and defense protection—a necessity for the public interest rather than a market commodity.”
I am fully aware that talk of rationing anything—energy, drugs, water, food, spending—may appear alien, politically toxic, even absurd in the context of today’s economy. But historically, people facing grave challenges often have preferred clear-cut, equitable limits on personal consumption to all-against-all strife.
So I’m betting that the ecological or medical ration card would be broadly accepted as a simple fact of life if our future society manages to achieve economic democracy while averting ecological crisis. As for how we can become such a society, well, that’s going to be the hard part.
Stan Cox’s book Any Way You Slice It: The Past, Present, and Future of Rationing will be published in May by The New Press. He can be reached at firstname.lastname@example.org.