Thursday, June 9, 2011

Liberals Defend RationCare

In the past several days, various liberal bloggers have come out to defend the RationCare program promoted by the Administration in the form of the Independent Payment Advisory Board.  The Center for American Progress blog makes “The Case for Bureaucrats in Health Care” by arguing that “there should be no question that if you give 15 bureaucrats in Washington a budget with which to run Medicare, that they’ll deliver health care services inside the budget cap.”  The problem is the access problems for seniors that will result from these arbitrary payment reductions to remain under the cap – the Medicare actuary said that the IPAB cuts would be “difficult to achieve in practice,” not least because other provisions in the law could result in 40 percent of providers becoming unprofitable over the long term.

Of course, the Center for American Progress (CAP) also proposed applying the IPAB’s RationCare scheme to the ENTIRE health care sector, which would subject ALL health care expenditures to a spending target – and could make individuals spending their own health care dollars above that target ILLEGAL.  CAP has yet exactly to explain how this provision would work:

  • Would individuals be subject to fines or taxes for daring to buy health care that bureaucrats did not approve?
  • What if someone wanted to fly overseas to obtain health care elsewhere – would they be permitted to leave the country?
  • Could individuals be jailed for having the audacity to pursue health care spending not approved by a bureaucrat?
  • Would doctors be subject to fines, taxes, or criminal penalties for treating their patients even though national spending levels exceeded the bureaucrat-determined cap?
  • CAP believes that women have a constitutional right to abortion.  How exactly does CAP propose to reconcile this purported “constitutional right” with the statutory spending targets it wants to place on ALL health spending?  Is CAP saying that women will always be able to obtain their “constitutional right” to an abortion, but may not be able to obtain pre-natal care if bureaucrats determine the spending target has been exceeded?

Separately, the Economist also expresses its support for having “experts” make health care spending decisions for all Americans, arguing that patients are unable to make these decisions for themselves because “health care is different:”

Patients aren’t going to experience a loss of freedom or satisfaction because an expert reviewer at the Independant [sic] Payment Advisory Board makes the call as to whether a procedure is medically beneficial, rather than the corresponding bureaucrat at their insurance provider or at the for-profit clinic they’re attending.  Health care is different from buying shoes.  Which is why it wouldn’t be at all surprising if a board of 15 experts could play a major role in reducing expenses and improving care outcomes in the American medical industry.

This argument TOTALLY misses the point.  If an insurance company “bureaucrat” makes an incorrect decision regarding a medical procedure, a senior can always go to another insurer and obtain coverage – but if government bureaucrats make such a decision, individuals likely won’t be able to obtain other insurance (not least because of Obamacare’s cuts to Medicare Advantage).

The fact that even Democrats are moving away from RationCare shows how unpopular the idea of having a board of unelected, unaccountable bureaucrats is to most Americans – even if liberal elitists continue to believe that “experts” should determine what type of health care all Americans receive.