Monday, October 12, 2009

L.A. Times: How we stopped worrying and learned to love rationing.


Under the Democrats' bills, rationing reimbursements would still be indirect. The vast majority of people would keep the same insurance they have now, whether they like it or not. The main change, aside from making insurance almost universal, would be an incremental shift in decision-making power, taking a bit away from insurance companies and giving it to the federal government. With luck, that will mean more transparency when decisions are made, maybe even a little more accountability. Under "Obama-care," if we don't like the way our health insurance is run, we can vote the rascals out. We can't do that to Blue Cross, Aetna or United Healthcare.

(emphasis, ours)

No, Doyle McManus of the L.A. Times actually said that. This entire health care reform legislative charade has been nothing more than a cautionary tale in the opaqueness of committee wheeling and dealing. But we're supposed to accept one of the 5 versions of health care reform currently floating around Capitol Hill in some vapor bill form or another because with luck it will mean more transparency when decisions are made.

The larger point of the article is that since we have rationing in health care we should just deal with it and, you know, accept even more because it’s the government doing it or something. We do indeed have de-facto rationing in healthcare because we have de-facto rationing on every goods and services we purchase. We’d love a new car every year but it ain’t happening because our finances dictate that we cannot afford a new car every year.

We’re currently rationing ourselves to a new car once every 10-15 years or so. We’ve been able to stretch out this acquisition cycle a bit because we made a sound investment up front and followed an out-of-pocket maintenance schedule that will, with luck, squeeze every last mile out of our beloved hoopdie. This is how things work in the real world.

And this is the dirty secret that the healthcare reform proponents don’t want to cop to: Healthcare costs money, plain and simple. You can wave your magic universal healthcare wand and give everybody coverage but that is going to result in some unsavory consequences. One of those consequences being it will disincentivize the medical technology field from developing new products and procedures because the government has deemed them to be non-cost effective.

Unfortunately, what the free market does now anyway in weeding out non-cost effective technologies which we wrote about here and here will be performed by an entity ill-suited to do the same.

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