By Hootsbuddy
Of all the arguments against health care reform, the rationing meme is the most pernicious. Arguments about politics, economics and taxes are contentious, but the possibility that a dying family member (or you) could be put out of misery as the result of rationed health care, triggers a visceral response that quickly runs rational discussions off the rails.
One of Mary McCaughey's earliest hit pieces resulted in an email whisper campaign beating the "rationing" drum as the stimulus bill was being discussed. Distorting the idea of comparitive effectiveness research, disinformation spread like wildfire among seniors. It is a persistent theme that will not go away even though it has not been an issue anywhere else in the world.
Dr. Robert Wachter's most recent post at The Health Care Blog confronts the "R-word" head on.
Yet rationing remains a political Third Rail, the Lord Voldemort of the healthcare policy debate.
After a thumbnail history of how the debate has been going on for much longer than the last year or two, Wachter gets to the nub of the challenge
There you have it. This is not a conversation about whether or not we're gonna have rationing. Rationing is already in place because the uninsured (and many who imagined that they were "fully" insured until the policy cap was hit) have the option to receive or not receive further care, framed clearly in economic terms. That, by definition, is rationing.
As the discussion continues, let's remember that it is a discussion of how best to apportion tax dollars, not that great reserve of private resources and responsibility I keep hearing about.
the insurance companies already ration it to those will policies as well
ReplyDeleteYou got that right. And those guys are positively salivating at the idea that they might get their hooks into everybody. That's why they fight any idea of a "public option." They know that without that alternative a large and growing population now without insurance must be insured at taxpayer expense.
ReplyDeleteI hope you guys get something re: healthcare for ordinary people though I suspect what actually gets approved and sign by Obama won't be as progressive as it may appear at first blush - sorry I think the Obama gang is really into spin more than much else and they seem really quite good at it. Ultimately I suspect there is a problem with the health services provision because you (sorry for using the royal you) conceive of it as simply another market supplied commodity which just leads down the usual dark ideological dead-ends. Obama himself always seems ambiguous referring to the provision of it as healthcare than in the next breath as the health industry - the guy is usually all over the place in his stump rhetoric so parsing his pontifications for any clear thought is a waste of time. Anyway just as a laugh here is a link to a pamphlet that was being circulated out in Saskatchewan when Tommy Douglas' (yes that Tommy, Kiefer Sutherland grand- dad) gov't brought in Canada's first single payer provincially provided healthcare system back in 1962:
ReplyDeleteFront
Inside
Back
Not much has changed, eh, in terms of arguments and concerns. Incidentally, for what it's worth, I'm quite happy with my OHIP (Ontario Health Insurance) and any changes to it would see me in the streets rioting.
Obama came into an almost no-win situation and is trying to make it work.
ReplyDeleteAmericans prior to the Thirties were accustomed to paying whatever they could work out with the doctor. Doctors, in turn, accepted what ever patients and families could afford. When Blue Cross, the first group insurance, was introduced in the early Thirties it was strictly for hospital care, and the only way the AMA tolerated it at all was that hospitals were obliged to be not-for-profit. Price controls of earlier years had physicians scared they would return. Blue Shield, an insurance plan for medical care, came along a few years later and again was opposed by the medical community. Again, they only went along when assured that there would be no controls imposed on their rates.
Nearly seventy years have passed with nothing stopping rate increases but the upper limits of the world's most prosperous (until recently) national economy. The day has gone that patients paid directly for medical care. The two big revenue streams for medicine are premiums (insurance) and tax money (Medicare/Medicaid).
Americans regard health care as something that someone ELSE pays for. We are like guests at a restaurant who enjoy big meals at someone else's expense and try to act magnanimous by saying "Let me get part of that tip," and even then they expect the host to say "Nah, forget it. You are MY guest."
When and if we get a true public alternative those who need basic care will be able to access it at a truly competitive cost (note, I didn't say "rate") which will give the much-worshiped private sector some real competition for the first time in our lifetime. Then and only then can costs get under control.
It is a shame that some Americans are so gullible, to the outlandish propaganda and lies spat in the newspapers, television and radio about Obama�s health care agenda. They have demonized the British, Canadian and other worthy plans. Hidden under a disguise cover, these radical entities are determined to keep the special interest organizations in absolute power. Comprising of the money-draining profitable insurance companies and their rich stockholders. They don't want any changes to the broken system of medical care, because it will hurt the status quo. I was born in England, in the county of Sussex and until the inception of the European Union and the European Parliament dictating to Britain. That they must accept millions of foreign workers, the nations medical system was exemplary. I never had to wonder if I would have to file bankruptcy, to pay my medical bills, or listen to the incessant ring of debt collectors on the phone.
ReplyDeleteOn several occasions I ended up in the cottage hospital and their was never a cost applied to it, never a ream of paperwork. No doctor, no hospital or specialist ask me for my Social Security number, drivers license or if I was covered by a predatory for-profit insurer. Today the British Isles is being submerged under a barrage of legal and illegal immigrants, who have never paid into the system, have caused some rationing. Prior to the importation of foreign labor my trips to doctor, to hospital, the eye or a dentist was paid from my taxation. Unless we pass a national health care agenda, Americans will never know what it's like to breeze through their lives, without worrying about paying for health care? Tell your Senators and Congressman you want an alternative to the--GET RICH-- insurance companies, before a Universal health care is killed. 202-224-312 REMEMBER THE INVESTORS AND STOCKHOLDERS DON'T WANT THEIR PIECE OF THE $$$TRILLION$$$ DOLLAR PIE DISTURBED. EVEN SOME POLITICIANS HAVE THEIR DIRTY FINGERS IN THE PIE?
AS AN ALTERNATIVE TO THE PRIVATE HEALTH CARE, A GOVERNMENT SINGLE PAYER SYSTEM WILL ASSIST IN REVITALIZING THE WILTING US ECONOMY.
Brittanicus, I took the liberty of deleting your duplicate comment. I notice by your Typepad commenting history you are quite the copy & paste artist. I've done a bit of that myself, but when someone like me looks at the record it tends to suggest you might be a one-trick pony. (Or in your case, two. We may not agree on immigration but we're on the same page with health care reform.)
ReplyDelete