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Health Care vs. Rationing

Our Readers Who Comment are all over a story by Alec MacGillis this morning that emphasizes the unanswered question of how health care would be rationed under whatever plan ultimately emerges (if one does emerge) from the legislative process.

As MacGillis notes, rationing is a dirty word in the health care debate, but it's the one our readers use. Some use it in horror describing what would happen in a government-run system; others describe horrors they have experienced from insurance-company run systems. A "no" from insurers for a procedure or a drug because of cost is, they note, rationing.

There is a significant discussion about how much care really old people should get since the fact is we're all going to die. And there is that unending argument, complete with anecdotes, about whether the citizens of Europe and Canada, who seem to live about as long as we do, get better or worse care in their systems, which undeniably deliver care for less cost.

We'll start with nbriggs, who wrote, "We already have rationing of health care in the US. The difference is that it is based on ability to pay, not need. After 38 years of practicing medicine , I have seen ample evidence of the harm this has done, to my patients, to the health care system, and finally, to the country as a whole. It's time to fix it."

longjohns said, "...Rationing is not necessary. But outcomes transparency is... At the end, the point of healthcare reform is not to either make or save money. It is about providing good care. It so happens that much expensive care is not now good care in this country because of the irrational insurance industry. That's why we need Mr. Obama's public plan."

But signof4 wrote, "We know who will say "no"--the federal government! And when government says no, no is the answer! And this is the whole problem!"

tdl62 asked, "What American lives is Obama willing to sacrifice with his government rationed healthcare? Your mom, dad, grandparents and children...."

marine2211 warned that "Anytime government becomes involved in the private sector, fraud and waste abound. When some pencil pusher (or Czar) decides that I do not need additional care over and above what they consider "reasonable", I might as well move to Canada and wait in line..."

indy474 wrote, "Let's face it. Just as with anything in life (or death) resources are limited. Numerous studies have shown that exorbitant amounts of money are spent on end of life care for people who will never, ever get better or return to anything like a "normal" life... Small children die of common, treatable diseases while 85 year olds get heart transplants. Yes, rationing makes sense."

FauxReal said, "What do we call it when the insurance company denies a test, a procedure, a prescription?... Let's stop acting as though rationing doesn't already occur with private insurance. The other cannard is a government bureaucrat coming between you and your doctor. Today an insurance company bureaucrat comes between you and your doctor... These are scare tactics employed by the GOP and the lobbyists. $1.4 million a day being spent on lobbying health reform to protect their business model..."

Tupac_Goldstein suggested that "The Obama must appoint a Denial Czar. This Czar would have the ultimate authority in healthcare. Done properly, he/she could rid us of troublesome old people who consume so much of our health care dollars but provide little in return. If we are forced into governmental health schemes this will surely come to pass."

lieb wrote, "Of course there will be limits. There are limits now. It is just that the insurance industry sets them and keeps the what/how/when of those limits to themselves... Whereas the corporate limiters remain secret and unaccountable, the federal (or state) ones can not..."

I include the following exchange without any knowledge about its veracity because it is an excellent example of the urban legend discussion going on about this subject:

edgar_sousa wrote, "According to my eye doctor, under nationalized medicine, if you have glaucoma in both eyes, you will not get eye treatment for the glaucoma until you go blind in one eye. Then the other eye is saved. That is rationing health care for you."

To which eabpmn replied, "No THAT STORY was in the news about a PRIVATE INSURER who refused to pay for treatment for more than one eye on the grounds that the treatment for the second was "not medically necessary" as the person could see with one eye. (BTW, the insured complained to the state insurance regulator and the insurer backed down and paid for treatment for both eyes.) Liars liars panst on fire.....perfectly describes the right wing fanatics!"

And FauxReal added, "Your doctor is a nut and you should quickly find a new doctor. They don't even have a bill yet let alone details. I have glaucoma and I have no fear of a public option. I'd be more concerned with an insurance company deciding something like that."

goldie2 asked, "Why should I have to support with my taxes those old people who are afraid to die? We all have to die...The old people take everything and so many of them are so selfish and don't want to share the health care dollars with the younger people. Shame on them."

But Aprogressiveindependent said, "Most or all of us know who will be exempt from any current or future rationing of health care, regardless of their illness, age or prognosis. The rich and politicians will get whatever health care they want or need. The people most likely to be shortchanged are elderly people with limited to modest incomes and assets, along with lower income people of all ages..."

Martial wrote, "They do not live less long in Canada or the UK than in the US; the notion that seniors are allowed to die is risible. Remember this: we spend more than 2.5 times what the average OECD country does for less than optimal care. That's a long way until we get to rationing."

dougeeca said, "Health care is already rationed. I cannot get the medication I need to treat severe psoriasis because despite my doctor's prescription, the insurance company will not cover it because it costs too much. However, without treatment I am likely to get a serious infection due to the open wounds on my body and end up in intensive care. This will cost far more than the medication. I would rather have a government worker making decision based on the most cost effective treatment versus the least costly..."

And youmustbejoking1 wrote, "I'm not seeing a huge differnce between my insurance company refusing to cover a procedure or a government bureaucrat refusing to authorize a procedure... after the hell I've gone through with scam insurance companies and fake health care providers, the government bureaucrat doesn't seem as worrisome as it once did."

We'll close with the cynicism of wmc418, who said, "Death by spreadsheet, whether by a private for profit insurance company or by a government agency results in the same outcome. The only real difference... is that the private for profit company would be always looking for a method [to] acheive greater profits versus a system designed to keep voters alive. Boil it down to political basics, money or votes, it isn't money that keep politicians in office, it's votes and dead citizens do not vote."

All comments on this article are here.

By Doug Feaver  |  July 8, 2009; 7:11 AM ET
Categories:  Health , Health-Care Insurance  | Tags: Health Care Reform  
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Next: No Prayer for Single-Payer?

Comments

Nobody would support one private insurance company provide all health care decisions yet some think one government system would be fair. I would prefer to take my chances with 1300 private companies competing for my business with the potential of legal recourse, if need be, than one Czar w/o options. One may love Obama and he may select a Czar with the wisdom of Solomon, but there will be other elections and other czars.

Posted by: flyover22 | July 9, 2009 6:46 PM | Report abuse

just read this calmly, and start worrying about things that matter, please?

http://www.snopes.com/politics/obama/birthcertificate.asp

Posted by: adorn300 | July 8, 2009 1:21 PM | Report abuse

There is no way I will support any health care plan until everyone, including all politicians, (including the president), all unions,judges, etc. are on the same plan. Nor will I support a health care plan that would be administered by the government. Too much control over our lives is controlled by this illegitimate government. Until Obama can be vetted according to the constitution, namely his complete birth certificate listing doctors, hospitals etc.; and all his school papers and papers from the Ill. government.

Posted by: sdrdk5 | July 8, 2009 12:00 PM | Report abuse

I will support BHO's healthcare IF: anyone can show me where in the US Constitution the executive or legislative branch is authorized to enact it.
Any takers?

Posted by: rkeeton88 | July 8, 2009 10:56 AM | Report abuse

The comments to this entry are closed.

 
 
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