Wednesday, January 5, 2011

I'll Never Ration. Not Me. Not I. - NYTimes.com

Opposition to health-care rationing is a little like opposition to growing up. It sounds great. It’s just not very practical.

A society’s resources are always limited. So we have to make choices about what we can afford and what we can’t. Not everyone can afford to own a vacation home — which means vacation homes are rationed. Not everyone can afford to live in towns with excellent public schools — which means that good public education is rationed.

Similarly, we can’t afford to try every feasible medical treatment on every patient. Instead, we make choices. The most obvious form of rationing is the millions of Americans who lack health insurance today. Most of them get less medical care than they need and, in the process, keep down the nation’s total medical bill.

But even those with health insurance experience rationing. How? In many ways.

This country has not spent the money to install computerized medical records, and we suffer more medical errors than many other countries. We underpay primary care doctors, relative to specialists, and we’re left stewing in waiting rooms while our primary-care doctors try to see as many patients as possible. Specialists are usually not paid for time they spend collaborating with doctors in other specialties, and many hard-to-diagnose conditions go untreated. Nurses are usually not paid to counsel people on how to improve their diets or remember to take their pills, and manageable cases of diabetes and heart disease become fatal.

At some point we'll need to accept the fact that we cannot all have every test, every operation, every treatment, every new medicine or see every specialist.

To read the rest of the article, click on the link above:

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