What health care rationing looks like (Example 774) (Updated)

Rick Moran
I think the best way to defeat Obamacare is not to complain about the cost, or that taxes will have to be raised to pay for it, or even that it promises to hurt more people than it helps.

No, the way to defeat it is to remind Americans why it was defeated in 1993; rationing of services by government.

Some would argue we have a de facto kind of rationing today. Some procedures are not approved by insurance companies and are too expensive for most patients to pay for on their own. This is rationing by price, it is argued, and is no different than government deciding what procedures they will pay for.

That's nonesense, of course. It is still the patients choice whether they want to pay for the procedure (loans, donations, etc.), or not. And the reason the procedure was denied by the insurance company in the first place was because it was  either experimental or, deemed not necessary. The fact that the government would probably make the exact same determination is lost in this kind of criticism. The difference would be that if government said you couldn't have the procedure, it would be final. They would be in the business of rationing services, not saving lives.

Rationing experimental procedures is one thing. But how about kidney dialysis? The following is from a comment left on my blog about health care reform. It is from a long time commenter on my site who quotes from the Canadian Medical Association Journal about the dialysis crisis  in the UK

"An acute shortage of dialysis machines is causing numerous premature deaths in the UK, a study by the country's National Kidney Research Fund indicates. More than 100,000 people have kidney disease but only 34,000 are receiving dialysis or have had a kidney transplant.

Of the 71 UK kidney treatment units surveyed, 12 have been forced to turn away patients. Other units reported that they have been forced to take emergency measures to accommodate increasing numbers of patients. Some offer patients  dialysis only 2 times a week instead of 3, while others hold overnight treatment sessions. Most units reported they were working at full capacity, with no appointment times for new patients. "Some providers acknowledged that the final options for such patients are conservative management and/or death," the report said."

In America, we already have too many kidney patients who need dialysis or a transplant for the services available. Fortunately, private insurance has stepped in and now covers home dialysis units that are life savers for thousands.

But those machines are ruinously expensive and one can easily imagine a government run system looking with a jaundiced eye on people over a certain age being approved for such a miracle machine. This is the consequence of putting bureaucrats and accountants in charge of health care. Choices are made based on bottom line medicine and not on what is best for the patient.

Defeating health care reform that includes the kind of massive intervention envisioned by Democrats is just about a lost cause in the House (there is a chance that moderates who think the bill too expensive and liberals who don't think it goes far enough will unite to defeat it - but that is unlikely). But I think there is a real chance in the senate to kill the bill by keeping it from coming up for a vote this year. And the way to do that is to talk about the truth; the only way to make government run health care work is by rationing services.

It worked in 1993 and it should work today.


UPDATE:

Randall Hoven in the comments points out that the statement about "over 50" kidney patients being sent a letter telling them to get their affairs in order may be an urban legend. The rest of the information is quoted correctly from that article in the CMA.

Until we can ascertain the provenance of the "over 50" story, we will remove it from the post.




I think the best way to defeat Obamacare is not to complain about the cost, or that taxes will have to be raised to pay for it, or even that it promises to hurt more people than it helps.

No, the way to defeat it is to remind Americans why it was defeated in 1993; rationing of services by government.

Some would argue we have a de facto kind of rationing today. Some procedures are not approved by insurance companies and are too expensive for most patients to pay for on their own. This is rationing by price, it is argued, and is no different than government deciding what procedures they will pay for.

That's nonesense, of course. It is still the patients choice whether they want to pay for the procedure (loans, donations, etc.), or not. And the reason the procedure was denied by the insurance company in the first place was because it was  either experimental or, deemed not necessary. The fact that the government would probably make the exact same determination is lost in this kind of criticism. The difference would be that if government said you couldn't have the procedure, it would be final. They would be in the business of rationing services, not saving lives.

Rationing experimental procedures is one thing. But how about kidney dialysis? The following is from a comment left on my blog about health care reform. It is from a long time commenter on my site who quotes from the Canadian Medical Association Journal about the dialysis crisis  in the UK

"An acute shortage of dialysis machines is causing numerous premature deaths in the UK, a study by the country's National Kidney Research Fund indicates. More than 100,000 people have kidney disease but only 34,000 are receiving dialysis or have had a kidney transplant.

Of the 71 UK kidney treatment units surveyed, 12 have been forced to turn away patients. Other units reported that they have been forced to take emergency measures to accommodate increasing numbers of patients. Some offer patients  dialysis only 2 times a week instead of 3, while others hold overnight treatment sessions. Most units reported they were working at full capacity, with no appointment times for new patients. "Some providers acknowledged that the final options for such patients are conservative management and/or death," the report said."

In America, we already have too many kidney patients who need dialysis or a transplant for the services available. Fortunately, private insurance has stepped in and now covers home dialysis units that are life savers for thousands.

But those machines are ruinously expensive and one can easily imagine a government run system looking with a jaundiced eye on people over a certain age being approved for such a miracle machine. This is the consequence of putting bureaucrats and accountants in charge of health care. Choices are made based on bottom line medicine and not on what is best for the patient.

Defeating health care reform that includes the kind of massive intervention envisioned by Democrats is just about a lost cause in the House (there is a chance that moderates who think the bill too expensive and liberals who don't think it goes far enough will unite to defeat it - but that is unlikely). But I think there is a real chance in the senate to kill the bill by keeping it from coming up for a vote this year. And the way to do that is to talk about the truth; the only way to make government run health care work is by rationing services.

It worked in 1993 and it should work today.


UPDATE:

Randall Hoven in the comments points out that the statement about "over 50" kidney patients being sent a letter telling them to get their affairs in order may be an urban legend. The rest of the information is quoted correctly from that article in the CMA.

Until we can ascertain the provenance of the "over 50" story, we will remove it from the post.