What does rationing mean in health care? Bob at InsureBlog wants to know how political candidates plan to “control health care costs without rationing health care.” It’s a good question, and as he points out, one that is rarely answered. But I would argue that we already ration health care. The nearly 46 million Americans who do not have health insurance don’t really have much access to health care. So care is very much rationed for them. It’s rationed by a system that sees health care as a privilege rather than a right. It’s rationed by a system that only provides care to those who are able to pay for it, either from their own funds (very few people really fall into this category) or with adequate health insurance.
Proponents of “free market” health care don’t see it this way. They probably wouldn’t call it rationing when quality health care is provided to those with health insurance, while those without health insurance are turned away. When people speak of “rationing” in health care, they’re likely referring to limited services for all of us, rather than no services at all for 15% of the population. But I think the word could be used to describe both scenarios.
For those of us who are insured: would we rather have a little rationing (in the form of longer waits to see a doctor for less serious conditions, and perhaps higher out of pocket costs for non-emergency treatments, for example), in order to allow everyone in the US to truly have equal access to health care? What about those of you who are uninsured? Would you be happy with health insurance that contained some limitations – or rationing – but provided good comprehensive coverage in the event of a serious illness or injury? I’m guessing the answers would be very different depending on which side of the insured/uninsured divide you’re standing on. At the Colorado Health Insurance Insider, we believe that everyone should have equal access to quality health care. And if that means that I would no longer have hundreds of doctors on my network, or immediate access to care for non-emergency conditions, so be it.
Many thanks to Julie from Workers’ Comp Insider for hosting a fabulous Cavalcade of Risk, where I found Bob’s article. And thanks to Bob for noting that decisions about health care (and indeed, pretty much all of our national policy) are ultimately made by our congress, not our president. So no matter how good a presidential candidate’s health care reform policy looks, he’ll have to win over congress in order to make any real changes.