Saturday, May 2, 2009

Rationing Health Care

Rationing Health Care

John Lott points out that the Obama Administration is finally admitting that part of how they are going to get healthcare costs down involves rationing:
Last Sunday on “Meet the Press,” Larry Summers, Obama’s chief economic adviser, let the cat out of the bag on health care. In explaining why universal health care wasn’t going to increase the deficit, Summers said that people are just getting too much unnecessary care. Summers claimed: “whether it’s tonsillectomies or hysterectomies . . . procedures are done three times as frequently [in some parts of the country than others] and there’s no benefit in terms of the health of the population. And by doing the right kind of cost-effectiveness, by making the right kinds of investments and protection, some experts that we — estimate that we could take as much as $700 billion a year out of our health care system.”
This sure seems like rationing. Total health care expenditures in the United States in 2008 came to $2.4 trillion, implying that Summers believes that the proper government regulations can cut health care expenditures by almost 30 percent. That would cut back health care a lot. Summers softened the blow by saying that right now the government wouldn’t have to cut expenditures by more than a third of that $700 billion.
Tonsillectomies have primarily been done because of acute or chronic throat pain. Where different people are willing to draw the line between pain and surgery is a choice that we have traditionally left up to patients, but unless you know something about the patient’s preferences it is hard to claim that a surgery was a “mistake.”
Rationing is part of how those "superior" government run health systems in Canada and Britain save money--by simply not providing the quality of care that the U.S. enjoys. (They may cover the whole population, but at a substantially inferior level.)

Lott also points out that one of the areas where there is clearly a lot of surgery that isn't medically necessary is....abortion. And whether you are pro-choice or pro-life, I think that we can agree that if the federal government is going to start defining what medical procedures are "necessary" and which are not, we're opening up the door to either significant restrictions on abortion in the interests of costs...or we're treating an elective procedure as "special" because it's a political football.

There's good reason to worry about the political football aspects of government control of healthcare. For example, Britain's National Health Service, which has been taking increasingly strict steps to deal with poor lifestyle choices to cut costs is poised to start paying the enormous costs of in vitro fertilization for gay couples. And at a time when Ontario province was rationing surgery so that a woman had to have her bladder removed (with, as you might expect, horrendous post-surgical results), the gay Minister of Health was promising (and probably lying) that the government was going to start paying for sex change operations.

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