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etc. - a little of this, a little of that - by Oliver Del Signore

And so health care rationing begins

Wednesday, August 1st, 2012

Congratulations to this week’s Comment Contest winner — Susan.


I’ve maintained for many decades that whenever government sticks it’s collective nose into something, costs go up while quality goes down. I’m hard-pressed to think of even one exception.

When Romneycare passed here in Massachusetts, we saw costs go through the roof, even though they’d previously been driven up by government mandating that insurers must cover a host of things most people did not need or want, would never use, but were forced to pay for anyway.

All went swimmingly, from government’s perspective, while federal money flowed in to keep down the cost of providing insurance to those who could not afford to pay for it. But even federal funds are not unlimited and as more and more people became “insured,” costs began to spiral out of control.

Now, a thoughtful person might wonder if getting government out of the health care business entirely might be the best solution. Repeal all the mandates and let the free market offer insurance products people want and can afford, for those who want insurance. Those who don’t want to buy insurance can pay cash or set up payment plans should they need health care. And the truly needy will still be cared for, as they always were before government decided to play doctor.

But thoughtfulness is not generally a trait one finds in the liberal politicians who run Massachusetts. They pass a health care bill requiring universal coverage, promising it will reduce costs for everyone once everyone is insured, then scratch their heads in confusion when all those newly insured folks, especially the ones who get “free” insurance, suddenly begin flocking to emergency rooms and doctor’s offices, driving up costs across the board. So they try a tweak here and a tweak there but expenditures continue to escalate until there is only one thing left to do — clamp down on costs by legislating spending limits.

Mass. lawmakers pass health care cost-control bill

Lawmakers overwhelmingly passed a 350-page health care cost-control bill Tuesday afternoon, a compromise between House and Senate leaders that sets spending targets for hospitals and doctors in the state and penalizes those that exceed them.

Governor Deval Patrick said he would sign the bill. “This is more than a good bill; this is a great bill,” he told reporters after visiting a Roxbury organization that seeks to reduce youth violence. “This is a commonwealth that has shown the nation how to extend coverage to everybody and to do it in a hybrid system with an emphasis on private-sector insurance with subsidies for those who can’t afford it. And now we’re going to crack the code on cost control.”

He said he does not believe the legislation will lead to layoffs in the health care sector or hospital closures. “There are going to be changes,” Patrick said. “But if those changes mean we get lower-cost and higher-quality care because care is being delivered in different settings — in homes, for example, in neighborhoods, in communities, rather than in hospitals — then I think that’s something we all ought to strive for and will strive for.”

The plan allows health spending to grow no faster than the state economy overall through 2017. For the five years after that, spending would slow further, to half a percentage point below the growth of the state’s economy, although leaders would have the power under certain circumstances to soften that target.

Supporters believe the bill will help moderate increases in insurance premiums for consumers and businesses. While the measure does not spell out specific cuts, health providers are expect­ed to expand efforts already under­way to slow the proliferation of some medical procedures, better coordinate care to keep patients healthier and out of the hospital, and steer patients to lower-cost care­givers.

Providers and insurers that do not meet the spending targets would have to submit “performance improvement plans’’ to a new state commission. Failure to implement their plans could lead to a fine of up to $500,000.

“This is going to save us $200 billion over the next 15 years, and it’s going to provide better quality of care and better access,’’ Senate President ­Therese Murray said in an inter­view Monday night. “This is a big plus for us. We’re once again in the forefront on health care in the nation.’’

Murray said the 350-page bill will build on the state’s 2006 landmark health insurance mandate, which ­became the model for President Obama’s national health care legislation.

House Speaker Robert A. DeLeo said in a written statement that “while this bill may seem complex, its goal is simple: to cut health care costs that burden businesses and consumers while not interfering with the high quality of health care Massachusetts residents enjoy.”

Click Here to read the rest of the article.

So, let me get this straight. This bill is going to save us all money by limiting the amount of money that can be spent on health care and while doing so, will provide better care for everyone.

That sounds an awful lot like what was promised when Romneycare passed and see how well that worked…or didn’t work.

What you will not hear anyone say, because the media outlets will not report it, is that simple logic dictates that if costs are capped while demand increases, either quality or quantity must be reduced to stay under the cap.

That means, your doctor might not order the expensive test that could pinpoint the cause of your pain. Instead, you get a prescription for painkillers. It means that when the guy who had a bypass operation in his fifties returns for a second procedure in his seventies, he might well be sent home with a “care and comfort” order to wait to die.

When you limit spending you must limit care. All the shuffling and dancing in the world will not get around that simple fact.

I’ve been telling all you kind readers who don’t live here in The People’s Republic to go to school on what Romneycare has done to us because the same thing is going to be done to you, eventually, thanks to Obamacare.

Watch us closely, because sooner or later, rationing will come to you, too.

5 Responses to “And so health care rationing begins”

  1. charles scamman Says:

    Aside from the revolving door at the FDA (and every other federal agency), the sad fact is that the feds and states all turn to the AMA for advice. The AMA is a “UNION”, dedicated to increasing profits for it’s members and does not necessarily have the best interest of the general public as it’s goal.

    HEALTH care is something done every day by the individual, or parent in the case of children. This should start with healthy food choices, but again, the agencies mentioned above have conspired to keep true information away from the public. Cherries prevent disease? Apples reduce cholesterol? Honey fights allergies? Don’t ask the FDA or the AMA, because they won’t tell you. And there in resides the key to getting to the starting point for “health care”… (at least in my opinion).

  2. Matt, another Says:

    It seems that when designing Romny-Obama care they deliberately built a system that would fail. There are reasonably workable systems that could of been modeled and tweaked to get something that works for us. Switzerland, Israel, even Mexico have systems that while not identical or perfect are workable.

  3. Mary Jane Says:

    My husband is 74, and I am 68. We are in reasonably good health…high blood pressure controlled by meds, some arthritis, and my husband has Chronic Kidney Disease, stage lllB. His nephrologist told us at his visit last month, “Well, before long, they will be telling you you’re too old to fool with.” I suspect our family doc is going to retire. My cousin, a gifted brain surgeon, retired very early.

    This said, consider my husband is still working full-time, contributing to the economy, driving our eighteen wheeler in a 7-state region, and paying plenty of taxes in dozens of ways. He IS self-made, in spite of what our president has said, and until early this year, we had another truck as well, employing another man, plus a part-time bookeeper. This driver was killed in an accident and we chose not to replace him or the truck, due to the fact that it was no longer feasible to make enough to justify it. Obamacare is going to put us out of business. My husband says he cannot retire until after the elections; it is too risky for us. We would rely on our Social Security and Medicare, which we continue to pay, plus unemployment tax, etc., and even though we own our home and have no debt, we would have to have that to live. He has worked since he was a child, and I had a long career as a Registered Nurse, so we paid and continue to pay our way. We raised four children the hard way: by the sweat of our brows. If this Obamacare is not reversed, our country has no hope.

  4. candace delaney Says:

    I’m not against so called obamacare, nor do I give it my support. The free market system for health care has not worked in this country becuase of one thing: GREED. Insurers put so many limits, exclusions, and restrictions on what they will, could, and would cover that unless you have very deep pockets, its impossible to afford – IF you could get it at all. Chronic or previous conditions? don’t even bother asking. THEN, add the government’s support of this system by making it nearly impossible for there to be any type of so called “alternate care”. being nearly illegal, it certainly isn’t covered under most regular health plans. it took government regulation to get “wellness” care, ie preventive. Since few doctors ever learned preventive medicine, they aren’t much help. and since there is no interconnection between these alternate systems, its impossible for the average human to navigate the maze of mis-information that’s out there. It is sad we need government information for there to be some kind of consumer protection out there for not just health care, but also banking practices, and other ‘necessities. and there is no free market in these areas. Whether insurance or banking, don’t see Humana, BCBS, or BofA, Chase, Citigroup, etc letting the simple, basic, mom and pop operation into the game.

  5. mike Says:

    “Repeal all the mandates and let the free market offer insurance products people want and can afford, for those who want insurance.”

    Products people want AND can afford? Good luck with that one.

    Insurance providers don’t control the cost of medical care. Insurance providers exist to maximize income for the owners. Same as any other business.

    The actual costs of medical care are not driven by insurance coverage or the lack of same.

    And spreading those costs to more purchasers does nothing to control actual costs.

    People are going to have to look under another rock to find that boogeyman.



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