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Rationing inherent in Obamacare

By: Ari Armstrong
August 14, 2009
0

The health reform debate has heated up mainly over rationing. On August 6, Mike Sola of Michigan confronted Rep. John Dingell. As Sola’s son watched from a wheelchair, Sola charged, “Under the Obama health care plan which you support, this man would be given no care whatsoever because he is a cerebral palsy handicapped person.”

That same day in Longmont, a cancer survivor told a crowd, “I’ve had a total of 11 surgeries. Do you think that Obama’s health care would have paid for that?” When the crowd answered “no,” he said, “Exactly. But I’m still alive today.”

A July 29 rally in Colorado Springs featured a sign calling Obamacare “a death sentence for seniors.”

Obama glibly brushes off criticism as “misinformation” as his supporters attack critics as un-American thugs and mobs. Yet rationing under Obama’s proposal is inevitable. The only question is how rationing would play out.

Obama would expand direct subsidies for care and force some to subsidize others through politically controlled insurance premiums. He also wants to push people into all-inclusive insurance and away from low-cost, catastrophic insurance that allows routine expenses to be paid through a Health Savings Account.

Giving people health care that is largely or entirely “free” at the point of service, often funded by others, artificially increases demand. Consumers ignore costs when something is “free.” Just imagine what would happen at the grocery store if politicians offered everyone all the “free” food they claimed to need.

Widely subsidized health care leads to exploding costs, and that leads to rationing, whether through lines or denials of service.

Rationing is common where politicians direct health care. A recent video from the Independence Institute shows how Oregon already rations Medicaid. John Stossel reports that hundreds of thousands wait in line for care in Canada and England. English headlines describe cases of delayed or denied treatment for patients seeking care from painkilling injections to heart surgeries.

As Duke history professor John Lewis points out, the “America’s Affordable Health Choices Act” explicitly allows for restrictions on hospital readmissions and “applicable conditions” covered.

Obama knows he cannot promise to cover every procedure for every individual. During a June 24 broadcast by ABC, Obama said, “Maybe you’re better off not having the surgery, but taking the painkiller.”

While Obama said such decisions would be between “doctors and patients,” he added that policies create “incentives” to guide a “good decision.” Who will decide which decisions are “good,” and under what political pressures to contain costs?

However, claims that some particular person or condition would not be covered under Obama’s plan prove difficult to sustain. There is simply too much we don’t know.

What will the final bill look like? How will bureaucrats implement the bill? How will the bill and its implementation change over time in response to rising costs? Which constituencies and individuals will move to the front of the line through political connections? Such questions cannot be definitively answered ahead of time.

It is precisely this uncertainty — the fact that Obama asks us to place our lives and health largely at the mercy of bureaucratic whim — that justifiably frightens people.

At his recent forum, Obama shifted the discussion from rationing to the problems with current health insurance. What he did not mention is that those problems are caused by prior political meddling, such as tax policy that has driven expensive, non-portable, employer-paid insurance.

Obama promises reform but offers only more political interference.

What we need instead is a renewal of liberty, in which individuals, doctors, insurers, and charities are free to interact voluntarily and direct their resources according to their own best judgment.

Armstrong publishes FreeColorado.com. He and his wife purchase high-deductible insurance and pay for routine, preventative care with a Health Savings Account.

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