Monday, May 18, 2009

How health care will be rationed

Dr. Emmanuel, Rahm's brother, by the way, should be credited for his honesty.

The ways costs will have to be cut:

1) Less amenities in health care. The hospital rooms are too nice.
2) Less use of the newest treatments
3) Doctors are currently too thorough. He even manages to criticize the Hippocratic oath, as it encourages doctors to go above and beyond to help a patient. This of course, is inconsistent with social justice, since not everyone can receive this time-consuming and expensive care.
4) Pharma companies need to stop advertising to consumers. If consumers know what's available, they'll demand it. If they don't know, then "There's nothing we can do" becomes much more plausible.

Oh, and one last one fro last year. Dr. Emmanuel wrote this in the Lancet:

“Unlike allocation by sex or race, allocation by age is not invidious discrimination.”

In plain English, it means that it's okay to deny certain treatments to the aged. Which of course is correct if you're going to provide good treatment to the young. But I don't think Medicare beneficiaries will willingly give up their Grade A care so that the young poor can get better care.

Of course, Dr. Emmanuel is right that we have an overutilization problem. There is some money to be saved in using older, effective treatments rather than always going for the newest one. I've gotten prescriptions myself for drugs that could be bought cheaper over the counter. One doctor gave me a prescription for Naproxen that was lower than the dosage in a single Aleve tablet. Naturally, I tossed the prescription and bought a bottle of Aleve. I was once prescribed Paridex for a gum problem that Listerine was actually more effective for. And I once got a prescription for ringworm that was cured by OTC Tinactin. So encouraging doctors to prescribe OTC stuff first where possible would probably be a good start. and yes, heroic, end-of-life care will have to stop except for those who can pay for it themselves. Sorry, Medicare folks.

The point of this is to understand just what will be involved with a government health care plan. the government will try to sell it as everyone getting gold-plated care. The reality is that it will be a heck of a lot better than having no insurance, but don't kid yourself into thinking it will be better than a decent, much less, a gold-plated, insurance plan. Understand what you're buying as a taxpayer, and judge the value of it vs. the cost. Oh, and keep in mind that they will lie about the cost, so at least double the expected cost before deciding if it's worth it.