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.