??' The Human Cost of Rationing Healthcare
July 18th, 2009 · This week the Congressional Budget Office projected enormous cost increases under the current congressional plan for national health care. It was promoted as saving taxpayers money, but the CBO estimates a cost over $1 trillion and it is likely to raise the tax burden for many Americans to close to 60% of their already dwindling incomes, as government bureaucrats balloon the cost of what is already the most expensive health care system in the world. The devastating financial impact of ObamaCare for the nation and every citizen is now overwhelmingly clear. But just in case you still harbor any illusions about how disastrous current proposals for national health care would be, I thought it was time to revisit the other cost " the cost in human suffering and loss of life under socialized medicine.
A key element of the cynically misnamed Affordable Health Choices Act, which is the plan currently being rushed through congress to meet deadlines and criteria set by President Obama, is rationing health care using Comparative Effectiveness Research (CER) methodology where government bureaucrats would set up schedules by which treatment would be allocated based on statistics and cost to benefit ratios rather than the interests and needs of the specific patient. Decisions on care would be matters of policy based on group effectiveness rather than on a case by case basis and doctors would have to abide by these decisions without regard to the welfare of the patient.
The impact of rationing in other nations where it has been introduced as part of the national health care system has been horrendous. It attempts to reduce the financial cost of the system by a trade-off which increases the cost in lives lost and individual suffering. Two nations with many similarities to the United States which have resorted to rationing health care are Great Britain and Canada. In both nations the human cost has been high and the results are easily quantified.
The failure of rationing comes down to two basic problems " denial of treatment and very long wait times. Both of these can result in suffering and death for patients, especially those with critical and chronic conditions which are treated easily and routinely in the United States today, but which often result in death in Great Britain and Canada.
One telling scenario of denial of care comes with cardiac patients. In the United States if you come into a hospital with an arterial blockage you are usually scheduled for an angioplasty or a bypass in a matter of days, because that is the best way to achieve a long-term solution to the problem. In Canada and Britain the common response is dictated by a shortage of surgeons and facilities, so you are given beta blockers to try to keep your heart functioning and sent away. If you're lucky you'll survive the months that it takes to get you scheduled for surgery or maybe come into the hospital in the middle of an actual heart attack when your chances of surviving the surgery are lower but they may actually operate. Or even better, if you live in Canada they may slap on a heart monitor and have an ambulance drive you to the US for treatment as they do with hundreds of cardiac patients every year. The sad reality is that many who are denied immediate surgical treatment for heart problems just die.
In the US a coronary patient is four times as likely to receive surgical treatment as in Britain. In the US only 5% of Americans are made to wait more than four months for surgery. In Canada 27% wait four months or more and in Britain 36% wait four months or more. While the base rate of coronary disease in the US is higher than in other countries because of diet and lifestyle, the rate of survival for those diagnosed with coronary problems is much higher than in other countries because patients get the best and most appropriate treatment more quickly.
The same pattern holds true with cancer. Overall Britons and Europeans in general die at a higher rate from all forms of cancer than US citizens and the difference is dramatic in cases where early detection and treatment are important. For example, women with breast cancer in Britain have a 46% death rate as opposed to 25% in the US. Men with prostate cancer in Britain have a 57% mortality rate while in the US only 19% die and the death rate is declining rapidly because of early detection. It's the same with colon cancer. In Europe as a whole there is only a 8% survival rate, in Britain there's a 40% survival rate and in the US there's a 60% survival rate. With cancer of the esophagus only 7% survive while in the US 12% survive, although it's still one of the most deadly forms of cancer. Both long- and short-term recovery and survival rates for all forms of cancer are also significantly higher for US patients. Rationed care has limited diagnostic facilities like MRI machines and has created long wait times for specialist doctors. In fact, 40% of cancer patients in Britain never get to see a cancer specialist at all, and the National Health bureaucrats have denied basic tests like pap smears and ruled out powerful chemotherapy medicines as too expensive, all of which has cost lives. With diseases like cancer where early detection and treatment are vital, resource rationing means a lot more dead patients.
The human cost of delay of care caused by rationing is particularly significant. One key element of this is the wait time to see a specialist who can provide the best treatment for specific ailments. In the US 74% of patients get to see a specialist within four weeks. In Canada only 40% get seen that quickly and in Britain only 42%. In many cases these delays can cost lives, but the cost of suffering has to be considered as well. In both Canada and Britain the wait times are even longer for conditions which are not life threatening, but can be very painful and seriously reduce quality of life. In Britain a hip or knee replacement can take more than five months and in Canada it can take as long as eight months. That's a very long time when pain is literally crippling.
An unsurprising irony is that as our congress looks at health care reform, activists in Canada, Britain, and a number of other countries are also looking at health care reform. The difference is that they are trying to figure out ways to introduce more choice and more market elements and reduce rationing at the same time we are plunging headlong into the same mistakes which they made a generation ago and which they now realize have left them with unacceptable failures in their systems with thousands of preventable deaths every year and millions stuck on waiting lists for essential treatment.
This is how bad it can get with government-run, single-payer systems, which may have a cost in lives and suffering, but do at least bring down the cost of health care. Imagine how much worse it could be with a combination of government bureaucracy and rationing and the high prices of private insurance and you have some idea of what ObamaCare will be like. It is likely to have all the flaws of socialized medicine while preserving most of the shortcomings of our current private insurance system, because the thousand-page bill which congress was considering is largely authored by lobbyists for the health care, pharmaceutical and insurance industries. It's like yet another bailout for these industries at a high cost in life, suffering and taxation to the American people.
Even the far left agrees that the health care plan currently being rammed through congress serves the interests of big insurance, medical and pharmaceutical companies while doing more harm than good to the average citizen. It rations and reduces the quality of medical care. It massively increases costs and forces small businesses and individuals to purchase insurance plans at inflated prices which they cannot afford or pay substantial penalties which they also can't afford. It passes many of these costs on to the public in huge tax increases. It doesn't solve the key problem of inflated insurance and health care costs and is projected to still leave 20 million people uninsured.
This may be the most monumental legislative disaster ever given serious consideration in the notoriously profligate halls of congress. This plan is not what the American people have in mind when they think of health care reform. It ignores their needs and sets their interests aside to pander to statist radicals and big business. The American people deserve better.
http://www.thefreelibrary.com/Inadequately+Funded+Universal+Health+Care+Leads+to+Rationing:+Part...-a0204073116
