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Healthcare rationing is the only future under Obamacare reforms

1:31 pm by | 5 Comments

Ohio, Wisconsin, Iowa, Kansas, Wyoming and Maine joined Florida and 19 other states in challenging President Obama’s healthcare law, and a federal judge just ruled in their favor. This means that more than half the country — 26 states — has made it clear they want nothing to do with the overhaul.

And for good reason. These states recognize that Obamacare will lead to widespread rationing and hurt American patients.

Consider Arizona’s recent decision to refuse seven kinds of transplant surgery under Medicaid, the state’s health insurance program for the poor.

While this transition could have been more incremental — some patients thought they were getting transplants, but were then rejected — the state’s decision wasn’t haphazard. It was based on evidence, which has been questioned by some, that these transplants had little chance of long-term success. Since the state’s decision, two patients have died and more may follow.

Liberals think they smell more than a little H-Y-P-O-C-R-I-S-Y. In what they perceive as a “gotcha moment,” they are asserting that it’s Arizona Republicans who have created “death panels,” not President Obama’s healthcare law.

But Arizona lawmakers’ efforts aren’t hypocritical; they demonstrate what critics of ObamaCare have been saying all along: When the government gets involved in healthcare, it will ration care.

It makes no difference whether Republicans or Democrats are in charge. ALL government-run healthcare is eventually rationed.

It may be rationed by setting a “global budget,” where the government determines how much it will spend on healthcare each year. That’s what countries like Canada and Great Britain do, which is the primary reason they spend so much less than us. Of course, there is nothing efficient or praiseworthy about setting an arbitrary spending level. It’s a very blunt hammer for controlling spending.

Healthcare can also be rationed through price controls. Imposing artificially low prices means that patients won’t have access to some medicines or doctors, which refuse to accept the price the government offers. Medicare, and especially Medicaid, exercise price controls regularly.

And the government can to its various agencies like the Food and Drug Administration (FDA) to ration treatments by refusing to approve certain medicines. Take Avastin, the cutting-edge cancer drug, regularly prescribed for cancer of the colon, breasts, kidneys, lungs and brain. While not a cure, it’s highly effective at staving off cancer’s progression by cutting off blood flow to tumors.

In December, though, the FDA revoked Avastin’s approval for treating breast cancer, despite strong clinical trials and impassioned pleas from women across the country. Though FDA officials deny it, many patients believe the decision was influenced by Avastin’s high price — about $8,000 per month.

Once this decision becomes official, insurance providers — including Medicare and Medicaid — will almost surely drop their coverage of Avastin, leaving dying women to face the no-win choice of either paying out of pocket or facing cancer with one less treatment option.

All government-run or government-financed healthcare is rationed because politicians, with limited budgets, must make political trade-offs. More money for healthcare means less money for education or welfare or police services.

The problem with the current unconfirmed head of Medicare and Medicaid, Dr. Donald Berwick, and so many other like-minded liberals is they have long operated as if all healthcare — whether government or privately funded — somehow comes under the government’s purview. And it will if Obamacare is left to stand.

While reasonable people can disagree on whether Arizona made the right cuts, legislators were trying to balance the costs versus benefits. The FDA also makes the claim that it is balancing costs and benefits in its decisions. Maybe, but look for even more Avastin-type decisions in the future as the government realizes it can’t pay for all the healthcare it has promised.

Of course, some claim that private sector employers and health insurers also ration care. That’s true to an extent; insurers and employers don’t always cover things patients want or need, but that’s determined by contract, not government fiat. And employers — and often individuals who buy their own policies — can, and frequently do, switch plans or change insurers if they are dissatisfied. When the government is in charge, there may be few if any other options.

Everyone’s heart should go out to those poor patients and their families who found themselves caught on the wrong side of Arizona’s decision. When the government rations care someone always loses.

Conservatives and Republicans have opposed Obamacare because it gives the government vast new control over the delivery and financing of healthcare, regardless of who is in charge. And when you do that you will get rationing, and you will, eventually, have “death panels” telling patients what they can and can’t have.

The author, Merrill Matthews, is a resident scholar with the Institute for Policy Innovation in Dallas, Texas.

Copyright 2014 MedCity News. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Merrill Matthews

By Merrill Matthews

Merrill Matthews is a resident scholar with the Institute for Policy Innovation in Dallas, Texas.
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5 comments
Peter Laske
Peter Laske

?? Healthcare is rationed today. I got canned at 60, I am now 62 and have not been able to get another job. What do you suggest I do about health care? Another little advertised fact by warped minds, those countries with universal health care that you say ration medical care have a higher standard of living than the US, the world is passing us by.

Anne
Anne

Correction- in my 100 plus count of CPAs- I meant Best, Anne

Anne
Anne

I sell payroll with one of the two national payroll companies in the country, and I call on CPAs in a metropolitan, blue-collar area of the country. My CPAs know the plight of their small business clients in trying to access good medical care. Not one in my 10 count of professionals I have built relationships with have communicated to endorsement of the Obamacare plan. I happen to sell in a state that is definitely swayed to the Democrat left with a large percentage of professionals in it and known for our research hospitals. I wonder what my CPAs who work closely with their small business clients would have against providing care for "everyone." It seems their hesitation is that the Obamacare plan is not sustainable, and they already understand significant rationing, besides other things, are now going to happen. I apologize for any typos. His was typed on my iPhone. Best, Anne

RBM_Wired
RBM_Wired

The opening statement of this polemic is absolute nonsense: "This means that more than half the country — 26 states — has made it clear they want nothing to do with the overhaul." That's garbage. The right-wing AGs in many states have filed suit against the bill and have won a preliminary ruling from a right-wing judge. To say that represents "more than half the country" is nowhere near the truth, nor is publishing this kind of made-up political crap from a far-right Dallas-based think tank without ID'ing it as such.

EA
EA

The fact is that healthcare is rationed today. Just ask the parents of children who've just graduated college and have the burden of having diabetes or asthma. They can't get health insurance. Or ask any middle aged exec who managed to get canned during the last downturn who still doesn't have a job with benefits. We've got a great system as long as you have an upper middle class income or you're employed with a major company. I don't know that the health care bill is a particularly good solution to the nations problems, but 8 years of republican de-regulation and coddling of the medical establishment have lead to a system that creates billions for top execs at companies like UHG, and leaves large swaths of patients uncovered. Maybe the solution is wrong headed, but behind your objections, I'm hearing that a push to make the world safe for investors. What happened to making the world safe for patients?