In the last few days there have been a few decent Q&A’s from the various news outlets to put healthcare reform into practical terms.
Here’s one from CNN today that was particularly good.
Question: Is there anything in the bill about rationing health care?
Answer: No one is using the term “rationing” as part of the bill. But there is a term called comparative effectiveness. And that’s this idea that we figure out what works in medicine and make sure to pay for those things. This also means that there are a lot of things being done right now where there’s not scientific proof that it works and maybe those things won’t get paid any more. Some people call that rationing. Other people say, look, rationing exists under the current system. It’s just that the insurance companies are essentially rationing by denying payment or dropping people off their coverage.
Ok, just because the word doesn’t appear in the bill doesn’t mean it won’t end up that way. I read a comment somewhere, that now that there are millions more people put into the healthcare system overnight…. where are the extra doctors and hospitals to accomodate that? When was the last time you actually made it into your doctors appt on time? How adding millions of people to the system isn’t going to lead to rationing, I’m not seeing it…. enlighten me if I’m missing something.
Hey Amy. I think the basic point is that “rationing” by itself is just a word that means different things to different people. Some take it to mean “pulling the plug on grandma” while others look at it as figuring out what the most effective treatments are and spending more resource on those. In a country where the average person spends a shit-load on their healthcare (with no significant improvement in actual health) compared to the rest of the world, I’m all for improving the system so we get more for our dollars, but it’s not going to be easy and it will take time.
As for the number of doctors, the CNN article commented on this as well…
It’s definitely a challenge but one that we have a few years to prepare for as those provisions don’t happen overnight, they get rolled out in 2014 I believe. Also part of the idea is that a lot of these people ARE already being seen but just not until they have to go to the ER when things get nasty and then our tax dollars pay even more for it anyway. A bit of smart preventative care up front could do a lot to reduce that.
And just for the record, don’t get me wrong… I’m sure it’s no where near a ‘perfect’ bill and I really can’t imagine what a ‘perfect’ solution would look like anyway for something as complex as healthcare. I am glad that after 15 months of intense debate, something is moving forward to make a start on it rather than continuing to drag heals and put it off for another couple of decades.