Well, I couldn’t get away to Wyoming without casting a little light on a revealing NYT. On one hand, it castigates critics of Donald Berwick–for, among other things, accusing him of promoting rationing for the USA. It’s all fear mongering, don’t you know. But, we need rationing! From the editorial:
Republicans are also eagerly, and shamefully, pillorying Dr. Donald Berwick, the new head of the Centers for Medicare and Medicaid Services. There are few figures who command greater respect for uniting health professionals and institutions to improve the quality of medical care while reducing costs. That is not stopping these critics from implying — baselessly — that he will introduce socialized medicine and death panels in this country.
The truth is that Dr. Berwick has praised the socialized British health care system, especially for its emphasis on primary care. This country certainly needs to do more to develop its primary care system. And he has, rightly, called for an open discussion of the health care rationing that is already widespread in our system. When insurers decline to cover procedures, or high prices screen out low-income people, that is rationing.
Dr. Berwick has endorsed the use of “comparative effectiveness” research to determine which treatments work best. He would use such research to judge whether a new drug or procedure is worth the cost of coverage, a step the reform law shies away from. He does not have the power to change that law. But the issue will have to be addressed at some point if there is to be any hope of restraining medical spending.
How dare those anti-rationers pillory a rationing advocate who understands we need rationing! Hilarious.
August 23rd, 2010 | 12:06 pm
So why is the present form of rationing that is rampant in our “health care” system “better”, more tolerable, or more desirable, than rationing which may occur under “Obamacare”?
Is it better to allow a rich, 90 year old man with prostate cancer occupy and consume all medical resources (from physician’s time to meals at the hospital), regardless of demonstrated effectiveness of said medical resources, simply because he wants such (useless) treatment and can afford it, while simultaneously forcing, due to economic necessities, an uninsured single mother in Detriot put off and/or gamble with primary care and preventive medicine until she may suffer a devastating stroke or heart attack?
The debate should be about better rationing.
It’s intellectually pointless simply to claim “rationing” – virtually every commodity is rationed in our economic system.
While the pied pipers may enjoy leading the minions, many watching from the home windows find such exploits quite the underachievement.
August 23rd, 2010 | 11:14 pm
I’m not sure your examples make a point, David. What is it you would like to provide the hypothetical single mother in Detroit that money and resources can buy and aren’t already being provided? Preventing stroke and heart attack are about risk reduction, which are precisely in the purview of primary care and preventative medicine. That these remain a “gamble” (if number-needed-to-treat can be referred to as such) is a matter of pathophysiology, not policy. I wonder if you understand much about the conditions you refer to. If what you’re saying is that the extraordinary treatments of poorly-responsive conditions are sucking resources from basic preventative care (i.e., treatment of hypertension, diabetes and dyslipidemia), it might serve our argument to rally some supportive data.
Until then,
CH.
August 24th, 2010 | 4:13 pm
[...] Wesley J. Smith points out a New York Times column which condemns health care rationing “fear mongers” while advocating for health care rationing. Pathetic, but hilarious. [...]
August 26th, 2010 | 6:51 pm
It’s a good point the NYT makes, and it’s good to see the NRLC supporting the New York Times on this subject. Kudos to Dr. Berwick for endorsing Comparative Effectiveness research so that we can decide properly which drugs and treatments are effective, so that we can fund properly and thus avoid rationing.
August 26th, 2010 | 6:57 pm
It’s a pity the health care reform bill was not about providing health care to everyone, but legislating abortion on demand (http://www.youtube.com/watch?v=Cqww8jmizug). They ditched the public option and mandated poor people buy health care rather than freely providing it, in the process of replacing the House bill with its pro-life Stupak amendment with the Senate bill and a new abortion agenda, risking healthcare reform in the process. And of course the Democrats receive a lot of money from lawyers and lobbyists (http://www.opensecrets.org/industries/totals.php?cycle=2010&ind=K01 and http://www.opensecrets.org/industries/totals.php?cycle=2010&ind=K02), so they excluded Tort Reform. We do need health care reform, as Berwick points out; and it’s a pity the recent bills were about legislating abortion instead.
August 27th, 2010 | 9:47 am
Craig wrote: I wonder if you understand much about the conditions you refer to.
He doesn’t. But false dichotomies such as the one he created are often invoked in this debate. Weak reasoning=weak argument.
September 12th, 2010 | 9:56 pm
[...] I got a big chuckle a few weeks ago when the NYT editorialized against rationing supposed fear mongering–and then pushed rationing. Well, the Old Gray Leftie Lady is at it again, claiming that the rationing comparative effectiveness panel established by Obamacare is not–listen to us!–not about rationing. Got that? It’s not! [...]
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