Three Reasons Why Health Care Rationing is Inevitable

!±8± Three Reasons Why Health Care Rationing is Inevitable

During a recent televised debate on healthcare reform between pundits on a popular 24-hour news channel, the topic of health care rationing came up. The anti-government-option pundit pointed out the necessity of rationing under the proposed legislation. The pro-government-option pundit retorted, "There already is rationing in the system. It's just rationed according who can afford to pay."

The significance of this exchange was the acknowledgment that there already is a healthcare shortage in this country. As noted economist Thomas Sowell once pointed out; "The first rule of economics is that there is never enough supply to meet demand. The first rule of politics is to ignore the first law of economics."

Without discussing the merits of any form of healthcare rationing, rationing is part of our medical system and will be a greater part of our system regardless of how health care reform manifests.

1. Free Market Rationing

Under the free market approach, healthcare is rationed, as the above pundit noted, according to who can pay. We also have programs of Medicare and Medicaid, as well as the Children's Health Insurance Program (CHIP) that disrupts the free market; however, as a generous nation, we are prepared to help the poor. Volumes have been written discussing both the merits and evils of the free market system and we're not prepared to tackle that issue here - yet.

2. Government Rationing

When the Obama administration speaks of reducing "inefficiencies" or "cutting costs" they speak of doing that through some sort of review board. That review board would, ostensibly decide which treatments are economical and which aren't thereby limiting available health care options. There's also discussion of the QALY program or Quality-Adjusted Life Years where the cost of one's treatments is weighted against the amount of years the individual may be reasonably expected to live. QALYs are used in Great Britain as a means of rationing healthcare. The Obama administration understands that there must be some form of rationing to manage costs. As Thomas Sowell would point out, when you take the price component out of any transaction you create shortages. There's no greater example of this than during the '70s when a well-meaning government fixed the price of gasoline and the result was long lines and people waiting for hours to fill their tanks.

3. Rationing by Inconvenience

When seeking the services of a health care becomes just too much trouble or nearly impossible, we call that rationing by inconvenience. The following anecdote related to my by a relative says it all. This is from a military family whose healthcare was entirely government-provided:

"Trust me when I tell you that I lived through this already. Back during the Carter years, the only health care option we had was military medicine.

If you needed to see a specialist, you had to call the main appointment desk starting at 8:00AM on the first day of the month. The phone number would obviously be continuously busy, so you'd sit there redialing for hours.

Once you eventually got through, 90% of the time the appointments for that month would already be filled. So, you'd have to wait until the first day of the next month and try again. This would go on month after month until you eventually realized that you were never getting an appointment and would go to a private practice specialist and pay out of pocket.

A friend's husband was an Army doctor and he explained that it's a conscious decision called "rationing by inconvenience." They won't tell you flat out that you can't see a specialist, but will make it virtually impossible so that you would either give up entirely or would go pay for your own treatment."

Are You Prepared?

One of the real crises of the current healthcare system is a lack of adequate health care providers. As government looks for ways of lowering cost without ways of encouraging more providers to enter the market, further shortages are inevitable. Rationing by cost, inconvenience, or government board all means that healthcare services will be more difficult for the public to obtain.