Why We Must Ration Health Care
Anyone who thinks we can avoid rationing must never read The Covert Rationing Blog. We have rationing now. Our rationing is covert as DrRich reminds us, but it is real enough. Patients ration in an irrational manner; their rationing depends on their financial situation.
If we must have rationing, and we must because we cannot buy all possible health care for all people, then we have a responsibility to make rationing overt and logical. Peter Singer explores the ethical case here and does a reasonable job.
Insurance companies engage in rationing in multiple explicit and implicit ways. They deny coverage because of lack of evidence – but usually just on expensive treatments or diagnostics.
If we must ration, then we need the best possible data to make decisions.
No one wants to discuss the R word. Rationing sounds so cold. It sounds so unfair. But every day physicians see the unfairness of life.
If we want to talk about fair, is it fair for someone who exercises, has reasonable weight and diet, does not smoke and only drinks in moderation to have higher insurance payments because his/her opposites will have much greater health care costs.
Fighting costs in health care can occur at many levels. Every citizen can help us lower health care costs through a healthier life style. The wonderful side effect is that those citizens will have longer life and better quality of life.
We must not exclude rationing as a cost control possibility. We avoid explicitly discussing rationing because the concept jars our sensibilities. I say that providing care for patients who refuse to take responsibility for their own health jars my sensibilities. I do the best that I can to counsel them, and provide excellent care, and to often I see health care dollars being wasted.
{ 1 trackback }