Another Skirmish Over Health Care

“Rationing!” exclaims David Leonhardt in the business section of today’s New York Times: “Wait, are you talking about rationing medical care? Access to medical care is a fundamental right. And rationing sounds like something out of the Soviet Union. Or at least Canada.” (See Health Care Rationing Rhetoric Overlooks Reality)

Leonhardt does not specify where this particular charge originates, but I suspect it’s from the insurance companies – and maybe the drug companies as well. In Monday’s post, I suggested that each of the stakeholders in the health care industry will seek to arouse in the public specific anxieties that suit their interests. Restricted access to health care is what the insurance industry wants us to fear. After all, that is exactly what they do by allocating only so much for each medical procedure, limiting providers, authorizing some drugs and not others, etc. But when Big Brother gets in the act, then, it’s “rationing.” The consumer can feel a helpless victim. More to the point, the insurance industry will have serious competition. And they may end up being dominated by government agencies setting policy, with the final effect being that they will lose profits.

“The r- word” will get a vigorous workout in Washington this summer, Leonhardt predicts, as legislators wrestle with the issues and deal with the buzzwords that sway voters. He makes the reasonable case that all health care services require some restriction. But “rationing” stimulates thoughts of deprivation, wartime shortages, governmental control, arbitrary restrictions and impersonal bureaucracies. If the insurance companies can persuade us that this is the most important thing to fear, they can hope to retain control over the distribution of health benefits. They will be the ones who determine how benefits get “rationed,” and their share of the $2.5 trillion industry will be safe.