Health Care Rationing is Here

The debate on the health care bill is so often snagged on talking points that have been around since Truman. A government health care plan will lead to bureaucrats rationing our health care!

"I don't think many Americans want to start having to wait in line [or] start getting government permission for procedures," Senate Republican Leader Mitch McConnell said last month on CBS's Face the Nation.

All too often, reporters are willing to accept that hoary old chestnut as the end of the discussion, so when Scott Horsley at NPR takes a deeper look at that idea, it's... refreshing.

But some doctors and economists argue that, in effect, the U.S. health care system is already rationing, in the most unproductive ways.

"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."

Anyone who gets their medical care through insurance today has experienced this rationing. It's far from invisible. You can see your doctor only if they fit the criteria of your plan. And every appointment, every referral, every test, every prescription is subject to the rationing of the insurance company.  That's for people who have insurance. For those without...

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.

Horsley's report doesn't break new ground. It doesn't delve into obscure statistics or show health care from an unexpected angle.

Instead it shows us the health care system we all know -- one that's already bounded by a severe rationing system that gives little consideration to anything but dollars.  What's extraordinary about the report is that it describes the health care system we all know and live with, not the one that fantasy system that McConnell pretends we have.