Thursday, December 30, 2010

Another tendentious op-ed from WSJ

The Wall Street Journal has many positive attributes, but clear thinking on health care issues isn't one of them. Today they printed an op-ed warning of the dangers of government rationing: by David Rifkin and Elizabeth Foley. Both authors are lawyers; neither has any background in health care. This paragraph was typical of the conservative/libertarian argument that there is a meaningful distinction between good private rationing and bad public rationing.

There's an enormous difference between government-imposed rationing and treatment decisions in the private sector. When insurance companies deny coverage—for example, on grounds that treatment is "experimental" or not "medically necessary"—they do so based on contract language agreed to in advance by subscribers. If you don't like what a particular insurer offers, you're free to shop around. Moreover, you and your doctor have extensive rights to appeal the insurer's denial, and wealthy patients can pay for the care out of their own pockets.

I have to confess I don't follow the logic of the arguments here. Only a lawyer could argue that it's OK to deny care because of contract language in a health plan (which no one I know reads), but let's leave that aside for a moment. I love the "You're free to shop around," point--there's nothing insurance companies love more than paying for expensive medications for sick clients. And when people are really sick, there really isn't a lot of time for waiting on the company to respond to appeals. And don't conservatives generally argue (correctly, in my opinion) that our resources are not unlimited and we need to restrain spending? How can health care costs ever be managed if any time a 3rd party objects to a treatment it is considered "rationing" and evil? Should we provide unlimited health care to everyone? If we should do that, why not unlimited food and drinks? Is it not rationing to only pay a thousand or so a month for social security? I mean at a million dollars a month seniors could have anything they want. Senior poverty would be eliminated. (Actually, no, people could still scream about rationing, because even at a million dollars a month there's a few things people can't afford).

I've posted it before,but this column by libertarian Steve Chapman explains well why the cry of rationing and death panels is demagoguery. These two paragraphs sum it up well:

No matter how we "reform" health insurance, there will still be close calls, where it's not clear that a costly procedure will actually do any good. There will have to be someone, either in government or in the private sector, to decide which operations and treatments should be covered and which should not.

What left and right have in common is the delusion that when it comes to medicine, nothing succeeds like excess. But no health care measure can alter the fact that our resources are not unlimited. We may not want to hear it, but no matter what kind of insurance system you have, sometimes someone has to say "no."

We don't have unlmited resources! What a bizarre concept! Like me, this guy probably just hates old people.

5 comments:

SINVILLE said...

"When insurance companies deny coverage—for example, on grounds that treatment is "experimental" or not "medically necessary"—they do so based on contract language agreed to in advance by subscribers. If you don't like what a particular insurer offers, you're free to shop around." No you are not. It is called a pre-existing condition and it will be excluded from further coverage. You don't address recidivism; the process is much more common that the red herring "experimental"

Jack Davis said...

We agree, sinville. I didn't actually use the word pre-existing condition, but I was criticizing the notion you can just shop around and get care from another company. You phrased it better than I did. Why not send the WSJ a letter?

SINVILLE said...

A letter to WSJ? Unfortunately Virginia O'Hanlon and I have very little in common; I've never sent a letter to the editor.

Jack Davis said...

So make this your first! I don't know who O'Hanlon is, by the way.

SINVILLE said...

Virginia O'Hanlon