Sunday, June 28, 2009

Universal Health Care and Rationing

In the current debate over a national health care system, we have heard a lot about how this will lead to rationing. The truth is that we have a lot of health care rationing under the current system.

Anyone who isn't rich or have a job with health care benefits suffers from rationing.

Elective surgeries, experimental procedures and procedures that are considered to be ineffective are usually not covered by health insurance. This is certainly rationing and who determines what is covered? The health insurance company. Or in some cases, your employer, who opts for a less expensive plan.

If you are not covered by health insurance at work and you have the money and you haven't already been diagnosed with a serious condition, you can sign up for any number of insurance plans. Every plan has limits (rationing) and you pay more for less rationing. For example, many of the lower cost options for women do not have any maternity benefits.

Rationing is often used as another term for "cost control".

Another complaint against universal health care is that people don't want to pay for other people's health care. They accept the shared costs of insurance, but object to paying for people who don't contribute any thing to the cost of the insurance. I believe these people think it is a matter of fairness.

But, of course, people without health insurance go to the emergency room and the cost of that care is passed along to people who use health care and can pay.

But even for many people with insurance, the costs are not shared fairly. Every employer plan I've been in charges different fees to the employee depending on how many people are covered. Covering just the employee costs the employee a lot less than covering the employee and a spouse. A family plan costs the employee even more except a family plan is the same cost whether the family has one child or ten. How is that fair?

Life's not fair, so why should paying for health care be fair? Health care costs must be controlled and that will inevitably lead to what some people will call rationing.

So lets have a discussion of the best way to create a health care system that is "fair" and affordable. "Rationing" will be one of the tools we use to achieve this.