What's your interpretation of rationed health care?

[napi21]

I just listed to a debate on MSNBC between the host & that Dr. who has her hown new show on that network. Most people say they want the best HC available, but they want it to be cheap. The Dr, talked about rationing, and mentioned a hypothetical machine that could extend life 10 years but it costs $10 million. Nobody can figure out how to pay for it.

I personally think that some extraordinary treatments should only be covered by supplemental ins. I have a HC directive that I've given my Dr, I have a copy here at home & my children are all aware I have a DNR instruction.

It seems to me that a lot of people get very frightened by the word RATIONING, but may no realize it might make sense not to cover everyone for things like transplants or bypass surgery for someone who is 85! Let supplemental ins. cover things like that if the individual wants it.

[Sherman A1]

1. What we have now

Health care is being rationed by the current system, is it not?

[napi21]

2. Yes, but most people don't believe it is. n/t

[endarkenment]

9. So we should aide the deceivers by accepting their false premise?

[eyepaddle]

15. Exactly, as a person who went ten years or so without insurance

I always thought that that was rationing right there. If you just tell 47 million people to get out of line entirely it frees up a few slots. I was always disgusted that nobody ever brought this up when having a debate about access.

[MajorChode]

5. Not only that, but there are almost no avenues for grievance or redress

If your private insurance tells you they aren't going to cover something, there's not much you can do about it. Certainly you can get another insurance company(so long as you're not locked into one by your employer), but chances are their policies are going to be the same or similar, or they are going to charge a lot more money.

When the government controls how health care is financed, no longer are decisions based purely on a business model. You also have an avenue of appeal through your elected representatives.

So it's not a question of whether it will be rationed or not, the only question is who gets to make the decisions regarding what is or isn't rationed. Then the question becomes do you trust people who ultimately must answer to the people, or do you trust a purely profit motivated company that is answerable only to stockholders?

[Sherman A1]

22. Not entirely the case

There is most certainly an appeal procedure that exists for your insurance. Granted it is a long an difficult path, yet the issue is never settled until YOU decide it is settled. There is also your state insurance regulatory body to whom you can appeal, again not the easiest thing to come up with a satisfactory solution, but one that you avail yourself of if needed. There is also that rather chilling effect of filing an appeal with your carrier in writing and adding CC: State Division of Insurance at the bottom. Somehow makes folks sit up and take notice.

That said I am an advocate of single payer and have written both my Senators to that effect.

[JonQ]

3. Problem is, where do you draw the line?

Who is deemed "worth saving" and who is a bad investment?

85 May seem old now, but in the not so distant future I imagine it won't be considered that impressive. Our social security system was initially built around the premise that a large number of people would die before 65, that was deemed old at one point too. Now I imagine if you told a 65 year old that he was told old to be worth the care he would take a bit of offense to that.

Same for a lot of different groups (premature children to name one large example).

[rurallib]

6. Those decisions are made now with a profit motive

and no one seems to care.
Health care rationing and end of life decisions are currently being done but the basis is whether the patient can pay. Once it hurts the bottom line, BYE!

[Phoebe Loosinhouse]

4. That what we have now is rationed health care

Do we not have life-time limits? Don't ever get breast cancer AND something else for God's sake! You'd be surprised how limits that sound large, like 1 Million get eaten up quickly.

[endarkenment]

7. Lying idiots: we already have rationed healthcare.

The question we are not talking much about is 'how should we ration healthcare' not 'should we ration healthcare'.

[Statistical]

14. +1. It is a good question "how" should we ration health care?

100% agree we currently ration care based on cost & availability.

Obviously unfair. How should we ration can more fairly.

given finite resources and infinte needs rationing is simply required in one form or another.

[shraby]

8. The old government run health care scares aren't

working anymore among the vast majority of people (over 70% want it) is because of the internet. Everyone who is connected can google other country's government run health care plans, communicate directly with people in those countries who have it and find out first hand how efficient they really are. How long it actually takes to get treatment if one is sick, how much they do or don't like their program and what it covers. We are finding out for the first time that the scare stories were just that...scare stories put in the news mostly by the insurance companies and legislators who are benefitting from the insurance company's largess.
We (average American) can now throw a hissy fit by using the internet to contact our representatives and let them know up front and personal just how gullible we aren't any more and to get on the stick and see to it that health care is a right for all of us.
They had better deliver on a package that covers all or they won't be government employees in a couple of years.

[justiceischeap]

10. I think the word "ration" invokes images of old ladies waiting in bread lines in Russia

Before the Soviet Union fell. It's a word used to scare people out of listening to this debate with an open mind. As others have stated, we already experience rationing. If you're lucky enough to have health insurance, most plans "ration" how often you can see a mental health professional, they "ration" whether or not you can have certain tests, they "ration" whether or not you can have treatment based on whether the insurance companies think it's elective or not. The list goes on and on.

There are many countries that offer a national health plan and though some may complain about the long waits, at least they don't go bankrupt at the end of that long wait.

[napi21]

12. The Dr. in that debate said something similar to what you just said.

She suggested the Dems fine another word to use instead of ration. Unfortunately she didn't have any suggestions. That was the gist of my post. People react to a word without thinking!

[justiceischeap]

19. That's the whole reason, IMO, that word is being used

To scare people off from Universal Health Care. I would suggest looking at the countries running government-backed health care and take some cues from them on the language they used to get it passed. I mean, I know France hates us for our freedoms and all and most people think of Canada as a joke and the UK as evil as the US but they somehow sold government-backed health care to their citizens.

[asteroid2003QQ47]

11. It is GENOCIDE of the people,by the people, for (2 or 3% of) the people!

I've said it here (and elsewhere) before and I'll never stop saying it.

If we don't have the balls to call it by it's right name,
how the fuck can we ever hope to defeat it?

[Hoyt]

13. Who should make the decisions?

As pointed out, the current system rations care, and it ain't rationed rationally. If you don't have coverage, you often have to wait until you are about to die to get care. Employer plans have been shifting the cost to employees for years (I'm not necessarily blaming the employers) and include a lot of exclusions. I think most people accept exclusion of cosmetic surgery, some aspects of palliative care, and similar services.

In any event, if we have to ration care -- which I reluctantly think we do to some degree -- it needs to be done under the auspices of elected officials, not some health insurance exec trying to bolster his/her bonus and increase profits for shareholders or an employer attempting to provide the cheapest coverage to fool employees into thinking they have a good plan.

[SoCalDem]

16. The doctor and the patient. n/t

[napi21]

20. Yes, but there still has to be some limitations.

For example...You can aford to buy a house...but not ANY house. Maybe you can afford a $200,000 house, but really want the $1,000,000.

A real life example is my cousin who had a pancreas transplant 7 years ago. He explained that he had to not only qualify medically, but they check your finances carefully. It's not only the cost of the surgery, but the medical maintaience costs for the rest of your life. For other reasons his health hhas been deteriorating and he's had to reduce his working hours, thus his income is down as well. He's 58 yo, insurance costs kept increasing $200-$400/mo. every year and about 1 1/2 years ago, he wasn't able to afford all his transplant meds. He finally was accepted into medicare under the disability program, but he reaches the doghnut hole by February each year! He has said many times if he had it to do again, he would not have had the transplant.

[Hoyt]

21. I wish it were that simple.

And, it might be in a world where health care professionals were not so heavily invested in equipment, etc., that is highly profitable -- as long as they can keep putting patients on it. I'd leave the decision up to Dr. Welby, but I'm not convinced Dr. Trump will do what is best for the patient.

I do agree that the physician and patient's decision should be the most important. But having a health system pay for everything that the patient and physician deem desirable will bankrupt us much faster than the current lousy system.

In any event, it's going to be tough going. But it's something we have to do.

[zorahopkins]

17. Nothing More Than This

Any talk of "rationed" health care is NOTHING more than a right-wing talking point.

Do not listen to any talk of "rationed" health care.

It is just a scare tactic to divert attention away from the need for affordable health care for ALL!

[harun]

23. Exactly, it is a FUD piece (Fear, Uncertainty, Doubt).

Good post.

http://en.wikipedia.org/wiki/Fear,_uncertainty_and_doubt

[wolfgangmo]

18. America has more rationing of health care than any other industrial democracy

Let's be clear on that. 50 million American's are told to get out of line for health care. Another 100 million who have insurance are told they can stand in line but they don't get into the "show" most of the time despite the fact that they bought a ticket.

That is right folks. 1 out of every 2 American's is rationed health care every day in America. American's are the only ones who have to make the choice to take little suzy to the doctor or put food on the table, or get treated for cancer but lose your families house and have to explain to little suzy why they are living in a 1 bedroom apartment and they don't answer the phone.

No other country allows non doctors to make medical decisions. In Canada, if your doctor decides you need a treatment, you get it. Period. And no clerk gets to decide otherwise. In the US, doctors are trained to check with the insurance company before making any decisions. Doctors here practice what a colleague, who moved his clinic and staff up to Canada, calls insurance medicine. He tells me that he practices medicine in Canada while in the US he used to practice filing insurance forms, writing letters disputing denials, and arguing with pinheads on the phone.

If we don't fix this by going to single payer, the system will; continue bankrupt Americans in record numbers (over 50% of all bankruptcy's are due to medical bills given to those who have insurance), drive the cost of doing business so high that companies of all sizes continue to fail, make it impossible for small companies to attract high quality employee's, and cause more homelessness than any other cause. And it can happen to anyone, with or without insurance. All it takes is one serious illness and one denial of claim and you are FUCKED. And so is your family.

America has the most rationed system on the planet and it is also the most expensive. It's broke. If it were a business it would be out of business. If it were a criminal, it would be behind bars. If it were a singer I would be out of American Idol in the first round.

Sigh. If we don't fix this then Canada will need to build a fence and a minefield to keep all the "yankbacks" out of their hospitals.

FYI, I have been to hospitals in Canada, the US, Costa Rica, Venezuela, France, England, and Australia. The worst service and the highest cost, by far, was in the US.

[Vinca]

24. The rationing talking point is the most foolish of all of them.

As others have noted on this thread, we have rationing up the wazoo right now from getting no services for the uninsured to getting some services but not all that are required for the insured. A big problem - and probably how the rationing meme got started - is that when you go to a doctor and care is prescribed, it's paid for "by the procedure." The more procedures prescribed, the more money is made. This started decades ago. In the mid-1970's I worked for a doctor who contracted with a lab for all his blood tests and the more tests that were run, the more money went into the doctor's coffers. Needless to say there were many tests run. A few years back I had rectal bleeding and the doctor ordered a sigmoidoscopy. That showed nothing so he ordered a colonoscopy. There was absolutely no need at all for the first test because a colonoscopy examines the sigmoid colon and if something had been found on the first test, the second test would have been required anyway. We are used to having a million unnecessary tests and now that sanity might be brought to bear, it's being billed as "rationing."

[Cleita]

25. Rationing is one of those scare words put out by the insurance industry

to frighten you. In actuality, rationing goes on with our system too, like a younger person will likely get a transplant organ before an old person. However, it's not why you think. It's because the doctors themselves don't want to risk an unsuccessful transplant on an elderly person, where it's more likely that this person couldn't survive a transplant. In disasters, there is the practice of triage when there are more casualties than doctors and medical facilities to treat them. Of course if people don't have the money for health care, they don't get it and that is a form of rationing. I don't know about that machine you are speaking of. Does it cost $10 million a treatment or for the machine, which everyone could use, which would considerably lower the cost per person.