The Government is Already Rationing Health Care
This is Scott Gottlieb, writing in the Wall Street Journal:
Take the agency’s tortured decisions concerning the use of implantable defibrillators that jump-start stopped hearts during cardiac arrest. Medicare sharply restricted their use in the 1990s. Mounting research proved that the $30,000 devices could be saving many more lives. So in 2003 Medicare adopted a novel theory to expand coverage to some, but not everyone, who needed one. The agency said only patients with certain measures on their electrocardiograms (called “wide QRS”) seemed to benefit.
It was an easily measurable but ultimately imprecise way to allocate the devices. After another major study firmly refuted the QRS theory, Medicare expanded coverage again in 2005, potentially saving 2,500 additional lives according to a press release issued with that decision.
That experience wasn’t unique. From 1999 to 2007, Medicare denied access in a third of the treatments it evaluated through its coverage process, taking an average of eight months to complete its reviews. When coverage was granted, in 85% of cases the treatments were restricted, usually to patients with more advanced illnesses.
Hey, it’s going to get worse. A lot worse.
When the Medicare entitlement was passed in 1965, did anyone envision it would be paying $30,000 a pop for implantable defibrillators? MRIs, gene therapy and modern titanium knee replacements hadn’t been invented yet.
Not only does the static, inflexible Medicare bureaucracy have a hard time keeping up with new medical technology, Medicare financing has fallen completely behind. To date, Medicare has promised to pay for tens-of-trillions of dollars of future medical procedures that haven’t even been invented yet. No wonder they need to ration.
Bruce, it’s going to get a whole lot worse.
That’s one of the problems with an open-ended entitlement. We could just about spend our entire GDP on health care as new treatments (both effective and ineffective) are developed. The tax rates will have to rise in order to cover the cost. Yet, there will be no easy way to make the trade-off consumer’s commonly make (e.g. do I buy a Ferrari and live in it? Or should I buy a Chevrolet and a house?)
Yes, everyone roaitns care. But at least in a system not run by the government individuals can decide on those trade-offs instead of bureaucrats. There will never be a system where everyone gets all the care they want when they want it. The best we can do is aim for a system that is most efficient with lowest cost. Our experiences with government-run care such as Medicare, TennCare and the MA plan implemented by Romney do not suggest that government can achieve such efficiencies.