The awful truth about government-run care: It’s rationing

Dr. Scott Gottlieb, a physician and resident fellow at the independent, non-partisan American Enterprise Institute, writes in today’s Wall Street Journal about the inescapable truth of government-run health care — it can only make health care cheap by rationing your access to it.

You may click here or pick up a copy of the Journal to read Dr. Gottlieb’s column.  Dr. Gottlieb writes in part:

President Obama objects when people use the word "rationing" in regards to government-run health care. But rationing is inevitable if we simply expand government control without fixing the way health care is reimbursed so that doctors and patients become sensitive to issues of price and quality.

Like Medicare’s recent decisions to curtail the use of virtual colonoscopies, certain wound-healing devices, and even a branded asthma drug, the board’s decisions will be one-size-fits-all restrictions. Such restrictions don’t respect variation in preferences and disease, which make costly products suitable for some even if they are wasteful when prescribed to everyone.

Moreover, these health boards prove that policy makers know they’ll need to ration care but want to absolve themselves of responsibility. Some in Congress and the Obama administration recently tipped their hand on this goal by proposing to make recommendations of the current Medicare Payment Advisory Committee (MedPAC) legally binding rather than mere advice to Congress. Any new health board’s mission will also expand over time, just as MedPAC’s mandate grew to encompass medical practice issues not envisioned when it was created.

The idea of an omnipotent board that makes unpopular decisions on access and price isn’t a new construct. It’s a European import. In countries such as France and Germany, layers of bureaucracy like health boards have been specifically engineered to delay the adoption of new medical products and services, thus lowering spending.