In the current debate over health care, the Right is pissing me off. They are whining about a “government takeover” that will lead to rationing and death panels, but also about runaway costs. Guess what?
You can’t have it both ways.
I just got off the phone with a Major Private Insurance Company. In order to save costs, certain tests must be pre-approved. In this case, I spent about twenty minutes on the phone, first with a clerk, then with a nurse (interspersed with a number of long hold periods). In the end, the study was approved. (I’ve never made such a call for a Medicare patient.)
This kind of prior authorization is a bureaucratic nightmare—I could have seen two patients in the time it took to get this done. On the other hand, unnecessary tests are a big waste of money, so the private insurance company would be crazy not to throw up a speed bump.
We already ration care. The question is not whether to ration care, but how. Currently it’s done by the faceless bureaucrats so feared by the right—-they just happen to be private faceless bureaucrats.
The Right needs to reassess its values—do they value cost containment, absolute health care freedom, or a libertarian dystopia where the rich get whatever they want and everyone else can fuck off?