Why rationing is a dirty word, and can we ever limit care in America?

Peter Singer confronts rationing of medical care head-on two weekends ago in a piece in The New York Times.

It’s gained plenty of traction within the blogosphere, but none better than hospitalist Bob Wachter’s opinion on the issue. In his take, he channels Joseph Stalin, saying, “A single death is a tragedy, a million deaths is a statistic.”

And that’s really the driving force behind the mindset against rationing medical care in the United States.

Dr. Wachter goes on to cite an example from Oregon, who initially denied having Medicaid cover a questionably beneficial bone marrow transplant procedure. When it comes down to “a hard-boiled tradeoff between a single identifiable life – in this case, a cute child with a determined mother – and many unidentified lives,” more than likely it will be that single life that takes precedent in America.

And that’s why, to the dismay of many health policy experts, an entity comparable to the UK’s NICE, who makes acturial decisions on what medical treatments gets covered, or not, will never happen Stateside. “An American ‘NICE,’” he writes, “isn’t going to limit ICU care for 80-year-olds with metastatic cancer.”

Indeed.

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