President Obama has nominated Dr. Donald Berwick to head the Centers for Medicare and Medicaid Services, and he sounds like a great guy for the job. Julie Rovner reported for Morning Edition earlier today that Republicans are stalling his nomination, which isn’t out of the ordinary these days. But the part of her story that really pissed me off was this snippet from Senator Pat Roberts (R-Kansas), who said, “Dr. Berwick is the perfect nominee for a president whose aim has always been to save money by rationing health care.”
I would really, really like it if everyone who gets involved in the US healthcare debate could acknowledge one thing:
HEALTHCARE IS ALREADY RATIONED.
We may not have an explicit healthcare-rationing policy on the books, but we already ration healthcare based on insurance status and ability to pay.
If you’re in the 15% of the population without health insurance coverage, you’ll have a hard time getting the healthcare you need when you need it (unless you’re a millionaire or you never get sick). Even if you do have good health insurance coverage, you’ll face limits on how much and what type of care you can get – for instance, your plan probably limits how many physical therapy visits you can get each year. And many people who have insurance miss getting recommended care because they can’t afford the deductibles or co-payments.
Whenever I hear politicians or pundits trotting out the “rationing” talking point, they imply that it’s something we have to stave off because it threatens the system we already have. That’s misleading, and doesn’t do anything to advance the much-needed national discussion about how we’re going to get the growth of healthcare costs under control.