Liberals screamed when Sarah Palin warned about “death panels” during the run up to the passage of Obamacare. But many really want health care rationing based on invidious methods of medical discrimination — as I have repeatedly reported here. I was just watching This Week and Steve Rattner — former adviser to Obama Treasury Dept. who has written in favor of death panels — alluded to them again. In a discussion on medical spending and cost control, he said (my transcription)
Rattner: Here is a small question for the country . . . Right now most Americans do not see price in deciding whether to use healthcare . . . When people go on Medicare, they really don’t see price, they tend to consume more than they otherwise would. Twenty-six percent of all Medicare spending is last year of life. We don’t know how much of that is really efficacious spending. These are really tough moral questions for the country but we are going to have to deal with them.
Kimberly Strassel of the Wall Street Journal caught the reference:
Strassel: What you are getting to though is the fundamental question: Are you going to let consumers make those choices about end of life decisions, or are you going to have Medicare make a decision about what procedures you can have and how much they will pay, and government make those choices. That’s the moral question.
Alas, the discussion moved away from the “moral question.”
But be clear, Rattner, and many, I might even say most liberals — want government making these decisions. And once it does, people will be denied treatment based on invidious categories, e.g., age, disability, quality of life, etc. And yes, single payer = health care rationing!
As I noted above, regarding rationing, Rattner wrote the following:
No one wants to lose an aging parent. And with price out of the equation, it’s natural for patients and their families to try every treatment, regardless of expense or efficacy. But that imposes an enormous societal cost that few other nations have been willing to bear. Many countries whose health care systems are regularly extolled — including Canada, Australia and New Zealand — have systems for rationing care. Take Britain, which provides universal coverage with spending at proportionately almost half of American levels. Its National Institute for Health and Clinical Excellence uses a complex quality-adjusted life year system to put an explicit value (up to about $48,000 per year) on a treatment’s ability to extend life. At the least, the Independent Payment Advisory Board should be allowed to offer changes in services and costs. We may shrink from such stomach-wrenching choices, but they are inescapable.
That’s the cost of centralized health care — in which decisions are often political — as we have seen ad nauseam out of the NHS in the UK. For example, some cancer patients in the UK are denied life-extending treatment but 42 year-old women can get free (but expensive) IVF to overcome their difficulties conceiving, which is not an illness but a natural part of the aging process.