NYT Openly Advocates Rationing

The New York Times recently published two OpEds openly advocating medical rationing.

The first was written by their economics columnist Eduardo Porter, "Rationing Health Care More Fairly" (8/21/2012).

His basic argument was that rationing was "inevitable", so the only question was how best to implement it.  In particular, he argued for a system like the UK's which doesn't pay for medical therapies costing more than $31k - $47k per year of life gained.  Similarly, he spoke approvingly of New Zealand's approach of not paying for vaccines if they cost more than $20,000 per year of life gained.

In other words, the only real argument (for Porter) was what exact dollar price the government should set on a year of an American patient's life.

The second piece was by Steve Rattner, an advisor to the Treasury secretary in the Obama administration, "Beyond ObamaCare" (9/16/2012).

Rattner admitted up front, "We need death panels".

Like Porter, he recommended stricter government controls to restrict medical spending.  His particular target was spending on the elderly, especially for people in their last year of life, which "consumes more than a quarter of the [Medicare] program's budget".

Of course, one big problem with this approach is that you often don't know what will be the patient's last year of life until after they've died.   It's easy for a bureaucrat to say after the fact, "Look at all that wasted money which didn't add much time to the patient's life".  But a physician on the ground doesn't always know if a patient will live or die from a surgery or procedure.  Should the government be deciding whether or not to try and save a patient's life?

These sorts of arguments are inevitable when the government controls medical spending, as it does for the Medicare population.  He who pays the piper calls the tune.  Under ObamaCare, such government control will quickly spread to the vast majority of the American population, not just the elderly.

I must admit to being surprised to see such open discussions of medical rationing so quickly.  Earlier in 2012, the New England Journal of Medicine still exhorted health policy analysts to avoid the "R-word" because it was such a political hot potato, and instead recommended using euphemisms such as "frugality". 

But if ObamaCare supporters are feeling confident enough to openly discuss rationing now, it means they'll be ready to put their plans into action if Obama wins a second term.

This coming November, American voters will have one final opportunity to decide whether or not to go down this road of "inevitable" government medical rationing.

At least the rationing advocates have given us fair warning of their intentions.  How we respond to that warning is up to us.