Wednesday, July 15, 2009

Who's really trying to ration health care

In the debate over the health care reform bills coming before the House of Representatives (pdf) and the Senate, the go to objection for conservatives and Republicans has been, "Do you want the government to be able to tell you what care you can receive?" Setting aside the logical inconsistency that care right now is rationed (either directly by insurance companies or indirectly through overpriced care and employment risks) this argument is hypocritical and self serving.

First, the bill linked above from the House expressly prohibits restricting coverage A (I)(C)(121)(c) pg. 26:

A qualified health benefits plan may not impose any restriction (other than cost sharing) unrelated to clinical appropriateness on the coverage of the health care items and services.

In fact, throughout all of Division A (the section that establishes both the public option and defines what meets the mandate specifications as an eligible private plan) the only restrictions this bill sets are on minimum quality of coverage. Most of these minimums go above and beyond what I see in private plans (mental health parity, elimination of pre-existing conditions, etc.) This isn't rationing of care, this is the opposite just as then candidate Obama promised on the campaign trail (although with the addition of a mandate as Hillary Clinton and John Edwards had proposed).

Throughout this entire debate I have heard only one group call for any government imposed restrictions on the type of care you can receive. This hasn't been Democrats trying to tell doctors to give this drug instead of that one. This hasn't been progressives trying to say which doctor you get to see.

The only people asking that the government not provide coverage has been Republicans. It is the Republican leadership and Congressmen that are trying to get an amendment passed that would restrict the care a woman can receive from her doctor. They want to impose a restriction on coverage that would prevent a woman from accessing legal safe abortions.

They're not trying to impose this restriction on medical grounds. They're not even trying to impose it based on cost savings. The one and only reason they have for proposing this is because their religious base says so. Because their religious base believes abortion is wrong, they want to deny this essential and sometimes life saving procedure to those who need it.

There is a reason our founders created a firm wall between church and state. They knew that forcing one's religious beliefs on another took away the freedoms of everyone. In fact, many of the first European immigrants came to these shores because others were attempting to force their religious beliefs on them.

Could you imagine the outcry if representatives with large Amish constituencies passed a provision banning the coverage for MRIs because they view that as wrong? Or Scientologists banning treatment of depression? The outcry from the "libertarian" right would be deafening. We can not let this hypocrisy stand or go unchallenged.

Remember this the next time you hear the "rationing" health care argument these reforms. Those who preach it the loudest already are the first to attempt to do so.

Please contact your Senators and Representatives and ask them to keep government out of decisions that should be between patients and doctors. Sign this petition from or contact them directly (Senator contact information, Congressperson contact information)


Comrade Kevin said...

Done and Done. They know how I stand, but one of my Senators seems to be more interested in proving that President Obama isn't an American citizen.

And as for Abortion, there are times I think it needs to be mandatory.

no_slappz said...

john j,

The average annual per-person cost of healthcare coverage in the US is around $6,000.

However, Medicare coverage for its 40+ million participants is $8,000. Hence, the government plan is more expensive than private coverage.

However, to give you an idea where costs in government plans will go, all you have to do is look at the New York State Medicaid Plan.

Overall, Medicaid covers another 40+ million people. In some locations, the per-person expenses are low. Nevertheless, the US average is about $5,000.

But New York State stands alone. The per-person annual cost of Medicaid in NY State is $12,500.

More than DOUBLE the national average.

As you mentioned, no one on the government side of the aisle is talking about rationing healthcare. But when the cost of something exceeds the country's ability to pay, there is no alternative.

Of course Americans believe they are entitled to any healthcare option simply if the option exists. Moreover, the country has gone to extremes to medicalize a long list of items, particularly where behavior and pharmaceuticals are involved.

Moreover, since the US has shown it is powerless to stop illegal immigrants from sneaking into the country, it is a certainty that millions more will pile in if we increase the amount of FREE healthcare offered to them.

The third leg of governmetn healthcare in the US is the Veterans Administration. Its per-person spending also exceeds the national average. And like Medicare, it too rations its expensive care. Medicare is rationed by age. VA services are rationed by military service. There are 23 million veterans.

Yet even by rationing services, these two organizations spend more than private healthcare suppliers. But Medicaid, which does not ration services in an explicit fashion -- eligibility by age or military service -- has recorded stunning increases in NY State, where about 25% of the population is enrolled.

As you said, the plan you envision puts no limits on care. Apparently the state of Washington agrees. It has already paid for the sex-change operation of a resident. This benefit has been utliized by about five others as well.

Thus, the precedent has been set. How does this happen? Medical experts declare that the procedure in "medically necessary."