WaPo 's Alec MacGillis notes that Obama's health care reformers
are clearly spooked by the notion that they could be accused of denying, for example, hip surgery to an 80-year-old.
If so, they largely have themselves to blame. They brought it up! It wasn't the Republicans who billed health care reform as a cost saving, budget-balancing measure that would start to deny payments for treatments deemed "ineffective," or (as one acolyte put it ) when "a person's life, or health, is not worth the price." And to think when they heard that people started to worry about rationing! Fancy that.
MacGillis also makes it clear that the Obama wonks are hiding the ball on the ultimate decisions their cost-cutting mission might entail:
A senior administration official who requested anonymity to speak candidly acknowledged that while research might point to obviously wasteful practices, the reform would for the time being not get at the "harder question" of what to do "if new technology does work better and reduces risks but costs a lot more, and how to evaluate that."
Unfortunately voters, who may deal with expensive new medical technologies every other day, aren't dumb enough not to see this "harder question" coming down the pike.
Why raise the cost-cutting issue at all? Especially if you're not going to do much about it !
In their unconvincing second-stage fallback arguments the "rationing" charge--Stage 1: No, of course we won't ration! Stage 2: Sure, we'll ration! But we're rationing now!--Dem reformers note that price is a particularly nasty way to limit access to health care:
Others retort that the United States already has rationing: The uninsured and under-insured do not get the care they need.
So why not bill health reform as ... giving the uninsured and uninsured the care they need! Hey, there's an idea. In fact, why not simply say you're reforming health care to provide health security to all Americans, including the always-anxious middle class--instead of suggesting that you are funding care for the poor out of the hip replacements of the elderly affluent? Give everybody the medical care Medicare recipients now enjoy in, say, McAllen Texas. Pay the bill with higher taxes. Then worry about reining in overtreatment and rationing later. (My bet: Voters will prefer to keep paying the bill, if that's necessary to keep the hip replacements and cancer drugs coming.)
P.S.: Kirsten Powers' excellent column today makes this same basic point. Except she has polling data to back it up. ... 3:33 A.M.