What's Rationing and Editing the Post



The Washington Post has a front page article today on the future of rationing in health care. The article opens:

The question came from a Colorado neurologist. "Mr. President," he said at a recent forum, "what can you do to convince the American public that there actually are limits to what we can pay for with our American health-care system? And if there are going to be limits, who . . . is going to enforce the rules for a system like that?"

President Obama called it the "right question" -- then failed to answer it. This was not surprising: The query is emerging as the ultimate challenge in reining in health-care costs that now consume $2.5 trillion per year, or 16 percent of the economy. How will tough decisions be made about what to spend money on? In a country where "rationing" is a dirty word, who will say no?

Indeed. The article then goes on to quote some supposedly smart people on how to define that "dirty word": 

Others retort that the United States already has rationing: The uninsured and under-insured do not get the care they need. "We're already doing it," said Stanford University epidemiologist Randall Stafford. "We're just doing it in such way that it doesn't service societal interests." 

While being sympathetic to people who cannot afford the kind and quality of health care they might want, that is not the same as being told by a bureaucrat that you can't have a treatment even if you can afford it. Or as my colleague Shikha Dalmia explained yesterday in her excellent column:

The left has been trying to address fears of rationing by trotting out an old and tired trope, namely, that rationing is an inescapable fact of life because every system rations whether by price or fiat. But there is a big difference between the two. If I can't afford caviar and champagne every night, any rationing involved is metaphoric, not real. Genuine rationing occurs when someone else controls access—how much of a particular good I can consume.

Or as I illustrated in my column on health care rationing

Imperfect as private health insurance markets are, if a customer doesn't like the decisions made by Blue Cross Blue Shield, Kaiser Permanente, or Golden Rule insurance bureaucrats, he can look elsewhere for his health insurance coverage. But if the government health care scheme becomes a monopoly, when the bureaucrats at the new Health Benefits Advisory Committee decide that a treatment should be withheld, that treatment will be withheld. That's rationing.

The Post also reported:

Massachusetts, which has achieved near-universal health coverage but is struggling with high costs,…

I offer this slight edit:

Massachusetts, which has achieved near-universal health coverage but and so is struggling with high costs,…