Wednesday, July 01, 2009

Doctors Say Health Care Rationing Already Exists

"In America, we strictly ration health care. We've done it for years," says Dr. Arthur Kellermann, professor of emergency medicine and associate dean for health policy at Emory University School of Medicine. "But in contrast to other wealthy countries, we don't ration medical care on the basis of need or anticipated benefit. In this country, we mainly ration on the ability to pay. And that is especially evident when you examine the plight of the uninsured in the United States."
Kellermann still remembers the young mother of two who came into his emergency room more than 15 years ago, suffering from a hemorrhagic stroke.

"We worked for 90 minutes to save her life, but basically she had burst a blood vessel in her head. She didn't have a chance," he says. "She had no health insurance, and when the money got tight, she had to make a choice — she could either buy the groceries for her kids, or she was going to buy the three blood pressure medicines she had to take every day."

Sadly, Kellermann says, for less than the cost of that futile, 90-minute effort in the ER, the woman could have had all the blood pressure medication she needed for the rest of her life. It was not a government bureaucrat who decided she should forgo treatment until it was too late — it was her own lack of health insurance that led her to make that choice.
It's not only the uninsured who are affected. Americans who do have health insurance tend to get a lot of procedures after they're sick — not because bureaucrats dictate that, but because that's what insurance and Medicare pay for.
Rationing is not limited to the health care industry. No other country devotes as much of its economy to health care as the United States. While Americans might not think of that as a choice, it means they have less to spend on everything else. Government payments for health care come at the expense of schools, roads and other services. The extra money that employers have to pay for rising health insurance premiums is money they cannot put into workers' paychecks.

"No worker gets to say, 'You know what, make my premium $1,000 lower by getting me a more efficient health insurance package, and at the same time, give me $1,000 more in take-home pay,' " says Harvard economist Katherine Baicker, who has studied the impact of rising health care costs on employee compensation.

So while there is no government rationing board handing out coupon books for heart surgeries, more and more of the nation's resources are being gobbled up by health care, often with little choice for individuals, and often in ways that no sensible person would choose.

Read it all at NPR

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