Rationing Care

It’s all about your money… or is it?

There are many reasons healthcare is as expensive as it is, including the advance of science and technology. But the absence of a competitive marketplace, overwhelming government regulations, and uncompensated mandates are also central to the problem.

Prior to government’s intrusion into the “sickness” market back in 1965 with the Medicare and Medicaid programs, patients could exchange a chicken for a tetanus shot. Patients knew their family physician as a friend. They did not find themselves waiting for hours in waiting rooms and they did not receive a surprise bill from the hospital when their insurance didn’t pay. Most often, they paid for their care at the door and it was affordable.

That said, a homeless person, injured on the street, would likely be able to walk out of the hospital after receiving emergent treatment after suffering an epidural hematoma (bleeding in the head). But, all the money in the world could not have saved Nastasha Richardson because she was unlucky enough to have hit her head in Canada, a government run and government rationed healthcare system where patients may not pay for their care.

In contrast, Americans decided that in the event of catastrophe, everyone will get care and every emergency room will be equipped to take care of a “real” emergency. It is a public commitment and we pay taxes to support that effort.

As we watch our government take over our lives and our health without debate or deliberation, we can only hope that Congress might start to take their “let’s deal with reality” medications and settle down to consider the precarious future they are navigating for America’s citizens.

Bear in mind that rationing in the case of Canada is not just about waiting in line to have your blood drawn or suffering an extra 3 years with back pain before your surgery is scheduled. Government run systems do make sure that treatment is NOT just about the money (our money). All the money in the world could not have saved Ms. Richardson. The government had already decided that helicopter transportation was NOT “appropriate or necessary” to move patients to medical centers where their lives would be saved.

In England, NICE, a group of so called experts, not unlike our new CER (Comparative Effectiveness Research) Committee, decided recently that a drug would NOT be made available for the treatment of some kinds of breast cancer. There is some good news in the case of British women who are diagnosed with breast cancer. They can still come to the United States and pay for treatment because we have not (yet) allowed our government to take over and destroy our most valuable possession, our RIGHT to make choices about our life and wellbeing and to pay for those choices personally.

Patients from all over the world who want to make a personal choice about their health care can still go outside their own government provided programs and insurance directed health care systems and purchase what they need in the marketplace, particularly if they are buying elective and routine services. On the other hand, American seniors who receive their care thru Medicare cannot purchase care from a Medicare provider (hospital or doctor) if the service is a “covered service.”

You can buy a mammogram for $75.00 and yearly lab work is less than $50. If a patient were to use their insurance to pay the claims, the mammogram would have been well over $200 and the lab over $200 and the claims would have paid as part of the deductible. Medicare pays the hospital (for the x-ray and the reading) $131.50 on average. Buying healthcare is not as much fun as shoe shopping but I would argue both are a necessity for our better health. As long as you are a non-Medicare senior, health care is affordable and negotiable.

If Americans would follow the trail of dollars spent in healthcare, they would soon
realize it is government mandates, regulations, and price setting that have accelerated the
rise in costs in health care, the same government who wants to tax and spend its way into our hearts and medicine bottles. The Massachusetts experience reinforces the fact that government intrusions only increase the cost of care. But, America’s free market, available to the world, remains the best opportunity to invest in our health. It isn’t about the money; it’s about our freedom to make life choices. It’s about life and death, America’s life and death and the preservation of our basic liberties.