Robert Knight: Call It What It Is: Rationed Health Care


ACRU Staff


June 10, 2009

This column originally appeared on The American Thinker on June 10, 2009.

Fresh from grabbing much of the U.S. auto and banking industries, the Obama Administration and Congressional Democrats are moving briskly toward nationalized health care.

In a letter to Senate Democrat leaders, President Obama has called for forcing all Americans to have health insurance, employers to offer insurance plans or pay a fine, and to create a government alternative insurance plan.

Any or all of these will lead to a government takeover of the health care industry. And that will result in rationed care, in which cost-conscious bureaucrats will decide who is worth treating. Should your grandmother get a hip replacement? Go down the hall to the queue outside Office 37-B and fill out more forms. We’ll let you know in a few months. Hey, you with the brain tumor. Get back in line.

Private health insurance, we are told, will still be offered. But the playing field will tip severely with the government’s enormous competitive advantages. Businesses and individuals will be tempted to abandon private care and take a ride on the government’s ambulance. When enough of them do so, the private system will collapse, and the government will take over with a single-payer system.

After First Lady Hillary Clinton failed to commandeer the health-care industry in the mid-‘90s, “progressives” have discussed doing it gradually. A centralized system would give the government the power of life and death over America’s families. Just the threat of withholding medical care is enough for most people to surrender other freedoms. Such a system also reinforces the idea that government is God.

The rhetoric is the same: “The health-care system is broken;” America “is facing a health-care crisis.” Never mind that America’s innovative health-care system is the envy of the world, developing more drugs and treatments than any other country.

Health-care reform is needed so that more people are insured and to reduce bloated costs, but the best solutions involve less government, not more. Several plans propose tax incentives for people to purchase insurance to control their own medical decisions. But these are ignored by most media, which are infatuated with massive government expansion.

In countries where the government has a heavy hand on medicine, like Great Britain, innovation is stifled. Patients face long waits for routine surgeries, and bureaucrats decide who gets certain treatments. The Institute of Economic Affairs in London observed in a report, Delay, Denial and Dilution:

“Of course, UK health care is cheap. We spend less on health carethan does any comparable nation, but the cheapness of the NHS is subsidised by the exhaustion and demoralisation of the staff and by the second-rate service it so often provides. It is the cheapness of the miser who knows the price of everything and the value of nothing. And it is a cheapness that demeans patients as supplicants and which hides the medical realities of rationing from them.”

The report examines some of the more dangerous realities facing patients:

“Often treatment is not withheld altogether, but it is delayed, sometimes with the result that the patient’s condition worsens. … About 50 per cent had to wait over a month and 20 per cent more than three months. Over one in three of those waiting said that their condition had got worse while they were waiting and 14 per cent claimed to be ‘in a lot of pain.'”

The Obama Administration and its congressional allies are carefully avoiding talk of a government takeover, but their proposals will do exactly that. And the result will not be better care.

Many doctors already refuse to take Medicare and Medicaid payments because filling out red tape for small payments isn’t worth it. In a Wall Street Journal column, Dr. Marc Siegel, who practices in New York, warns that further government encroachment will make things worse:

“None of the current plans, government or private, provide my patients with the care they need. And the care that is provided is increasingly expensive and requires a big battle for approvals. … The doctors that remain in this expanded system will be even more overwhelmed than we are now. I wouldn’t want to be a patient when that happens.”

The strong temptation will be to shift from the best care to the cheapest. The infirm, the aged, and babies with defects will be the first to bear the brunt of the “savings.”

We already have a picture of such a grim future. Randy Stroup, 53, a cancer patient, applied for aid under Oregon’s state health plan in 2008. He got a letter denying payments for chemotherapy, but offering money to help him kill himself.

Under government-rationed health care, the idea of “compassion” is likely to take on a whole new meaning.



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