One of the right’s favourite attacks on Obamacare is that in order to keep costs low, it will be forced to introduce “rationing.” It’s an ugly word and concept that calls to mind WWII, gas lines and central planning, and apparently the charge has resonated.
Today Martin Feldstein has a WSJ op-ed titled: Obamacare Is All About Rationing.
Although administration officials are eager to deny it, rationing health care is central to President Barack Obama’s health plan. The Obama strategy is to reduce health costs by rationing the services that we and future generations of patients will receive.
The White House Council of Economic Advisers issued a report in June explaining the Obama administration’s goal of reducing projected health spending by 30% over the next two decades. That reduction would be achieved by eliminating “high cost, low-value treatments,” by “implementing a set of performance measures that all providers would adopt,” and by “directly targeting individual providers . . . (and other) high-end outliers.”
The president has emphasised the importance of limiting services to “health care that works.”
What’s funny about the rationing line of attack is that it’s the mirror image of the left’s attack on private health insurance. When John Edwards was running for President, and he’d bring up to stage with him someone whose parent had died because their private insurer didn’t want to pay for an experimental, end-of-life treatment, he was attacking rationing.
The only difference is that the private insurers makes decisions about an individual’s life basted on — gasp! — their own profits. While under a government program, such decisions may be made by — gasp! — some pencil pushing bureacrat, going by guidelines developed by a wonky academic.
But if anything, this charge against Obamacare gets it exactly wrong. What we should be concerned about isn’t rationing, it’s the failure to ration. The thing is, there’s no better rationer of care than the free market. But government, heavily influenced by politics, the desire to be re-elected, and the medically-thirsty elderly population, will have little stomach to make actual difficult decisions. Look how quickly the Democrats have already caved on just having end-of-life-care discussions, as part of reform, because some yahoos called them “death panels.”
Bottom line, what we should fear is the spiraling costs from an inability to ration. The problem is, for opponents of reform, that’s not quite scary sounding enough.
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