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

By: psytrist

psytrist — Thu, 30 Jul 2009 22:22:00 +0000

If we all paid for our own care out of our own pockets we would ration it for ourselves, especially by being more critical of the unnecessary things we are given now, and be more satisfied with the result. We could do that if we all had a well regulated health care savings account where we put the money we are now giving to insurance companies.

By: Med Student

Med Student — Wed, 29 Jul 2009 01:14:45 +0000

I apologize. I should have been clearer. I meant that “we” as in the government shouldn’t be the deciding power in regard to medical issues. I want the government as far away from this as they can be. Look at the Indian Health Services or even the VA. They are a perfect example of inept government management. Canada and England continually demonstrate why government should stay far away from this issue. Some disagree and are willing to accept the problems that come with government run health care in place of the problems we have now. I’m not. I didn’t go into medicine to have the government tell me how to practice. But that is what will come from this junk proposal. Its only a matter of time.

Normally I would explain my thoughts regarding rationing, in my own words, but I think this time I will just insert this link to a Forbes article. It is explicit. http://www.forbes.com/2009/07/21/rationing-health-care-opinions-contributors-scott-atlas.html

One last thing; I do agree that we have a problem but I do not agree that the proposed bill is a solution.

By: Pankaj Karan,MD

Pankaj Karan,MD — Tue, 28 Jul 2009 17:25:59 +0000

The inherent meaning of HMO medicine is rationed medicine for whole polulation. As an Internist we hget denial for necessay medicines and services on daily basis. Rationing is there for different level of consumers. Fo rmedicaid pts, rationing is rampant but not so mcuh for Medicare pts. For Medicare advantage rationing is done to make sure there is enough profit for HMOs and IPAs.
Le’s not be disallusioned that we have the unrationed and uncontrolled healthcare delivery system.When a healthcare deliver is based on profitabilty, then profitabilty depends on rationing.
Pankaj Karan,MD

By: Jeff Brandt

Jeff Brandt — Tue, 28 Jul 2009 12:45:45 +0000

Med Student, are you suggesting that we have no control over spending in health care? I think you are wrong that private insurer will be run out, It definitly is not the current plan. Argentina has many private health medical groups/insurance companies that work along side of the government provided care. http://www.swissmedical.com.ar/, Hospital Italiano http://www.hospitalitaliano.org.ar

Not sure what “BS” you are referring to, please explain. What is your suggestion that we do nothing about health care reform.

I look forward to your response, me nephew is planing on going to med school.

Jeff Brandt

By: Med Student

Med Student — Tue, 28 Jul 2009 04:35:45 +0000

“We” do not ration care. What you are all citing is not rationing. True rationing will exist however when the government takes control of health care and runs the private insurer’s out. Then Uncle Sam will be the only game in town and we will actually have true government mandated rationing. In fact the republicans recently proposed a bill in the house that would have made rationing illegal. Its not a surprise that not one democrat voted for it. Wake up people and smell the BS coming in the form of a “health care bill”. I should have went to law school.

By: Michael Kirsch, M.D.

Michael Kirsch, M.D. — Tue, 28 Jul 2009 02:04:14 +0000

Rationing is alive and well in America. Resources are finite. Since people do not have access to every available medical benefit, then rationing exists. The concept of restricting services will become strengthened, as it should, through successful health care reform and comparative effectiveness research. It won’t be called rationing, however. Obama will convene a council of linguists to craft the most palatable euphemism to soothe us.

By: Stalwart Hospitalist

Stalwart Hospitalist — Mon, 27 Jul 2009 13:21:51 +0000

If we can’t ever limit care, then we might as well sit back an enjoy the ride as long as it lasts. Since the system is financially unsustainable, rationing will occur at some point.

The question is whether we should actively design and debate the process now, or whether we should wait until the system implodes from lack of funding and then try to make these decisions in that environment.

Those who argue for the status quo — “we have the best healthcare here in America” — tend to leave part of that statement out: “for now.”

By: NoVA doc

NoVA doc — Mon, 27 Jul 2009 13:14:27 +0000

We ration care stateside in other ways as well: I’m thinking dialysis in patients with dementia, organ transplants in most patients age >65. The H1N1 vaccine in the US will be administered very differently from the seasonal flu vaccine, given to those who would benefit the most. The article is a much needed eye-opener for those who aren’t in the know.

Agreed, the end-of-life approach to health care in the US approaches ridiculousness. Grossly oversimplified, medical care is about ultimately forestalling death with the best quality of life possible, we hope (cue the “life is a 100% fatal sexually transmitted disease” joke.).

By: SIIIIMMD

SIIIIMMD — Mon, 27 Jul 2009 13:05:36 +0000

It is really hard to let go of loved ones. Sometimes it takes multiple trips to the ER, hospitalizations, stays at skilled nursing facilities, and readmissions before everyone comes to terms with the fact that aggressive care is “futile.”

By: Happy Hospitalist

Happy Hospitalist — Mon, 27 Jul 2009 12:56:18 +0000

Perhaps we could bundle the care of that 101 year old and physicians would not offer intubation in 101 year olds.

As they shouldn’t. Unmanaged expectations have consumed Americans.