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Rationing Health Care
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11441 |
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Section : |
CURRENT ISSUES
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| Issue
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4 / 1994 |
2,377 Words |
| Author
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James L. Napier, Jr.
James L. Napier, Jr., is a neurologist in private practice in
Cleveland, Ohio. |
Two-year-old Joel Bondy of Canada needed lifesaving heart surgery. The Ministry of Health, however, deemed his condition less urgent than that of other children, and his surgery was postponed repeatedly. Alarmed by Joel's deteriorating condition, his parents arranged for him to have the operation at a Detroit hospital.
Embarrassed by the resultant media coverage, the Canadian government said Joel would be moved to the top of the waiting list and surgery would be performed immediately in Canada. The hospital Joel was assigned to was a four-hour ambulance ride away. Upon arriving, however, there was no bed available in the hospital, and the family, including critically ill Joel, was moved to a hotel for the night. Joel died the next day.
In Canada, where government controls health care, an estimated 1,379,000 people wait for medical care. Nearly half of the 177,000 waiting for surgical procedures say they are in pain; at least a quarter are considered urgent cases. Even doctors cannot plead for additional services, says a Canadian neurologist: "What I considered essential services were unavailable. I recall losing an argument with the radiologist on call over whether a patient with a new stroke should have a brain scan at 5:06 P.M.; he judged that the situation was not an emergency serious enough to warrant performing the procedure after regular hours."
What might happen in America should the Clinton administration's Health Security Act be enacted? Rationing is legally possible and economically necessary in the Clinton plan. All Americans will be required to purchase a standard benefits package, and the growth in premiums for that package will be capped at a rate well below that of health care cost inflation.
There are several other price controls and budget restraints within the system. "Anytime you limit a commodity by limiting total related expenditures, you engender shortages that can only be solved by rationing," says Michael Tanner, Cato Institute director of health and welfare studies.
"Expenditure controls must, by definition, ultimately lead to rationing," says Edmund Haislmaier, senior policy analyst for health care issues at the Heritage Foundation. In the Heritage Foundation publication Why Global Budgets and Price Controls Will Not Curb Health Costs, Haislmaier describes the side effects of the 4,000-year-old concept of price controls. Among the highlights:
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