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It's Not Rationing, Stupid!

Monday, 13 July 2009 10:01 By Dean Baker, t r u t h o u t | Perspective | name.

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Republicans play on fears of rationing in health care in their fight to defeat health care reform. (Photo: José Goulão / flikr)

    The insurance industry, the pharmaceutical industry, the A.M.A., and the rest of the axis of evil opposed to meaningful health care reform have been working overtime. They are desperately trying to come up with reasons why people in the United States can't enjoy the same quality of health care as people in other wealthy countries at a comparable price. They want us all to believe that we will always have to pay two or even three times as much for care that produces no better outcomes.

    That's a hard sell, but fortunately the industry groups have lots of money to make their case. They think that they have produced a winning formula. It's called "rationing."

    Their focus groups showed that people dislike the idea of rationing health care. So, the industry boys have been running around warning that President Obama's health care plan could lead to rationing. They want everyone to believe that the government is not going to let you or your loved ones get that medical procedure that is necessary to stay alive.

    It's a great story of the industry boys, but it has nothing to do with the world, which is apparent on a moment's reflection. The most radical proposal on the table at the moment is a public health care insurance option. That means people would have the option to buy into a plan run by the federal government.

    Like other plans, a government-run plan would pay for some procedures, but presumably not pay for others. Is this rationing? If you don't like the government plan, don't buy into it. Where's the rationing?

    Suppose employers can buy into the government plan for their workers, so you get stuck with the government plan because your boss liked it. Well, tens of millions of workers have bad health care plans because that is what their boss selected. What will have changed because we have a public plan?

    Furthermore, even if we only had a public plan that everyone had to buy into (something which is clearly not on the table), it still would not amount to rationing. If there were a medical procedure that the plan would not cover, then anyone would still be entirely free to pay for the procedure out of their own pocket. Where is the rationing?

    Rationing is when the government limits the supply of a good or service so that people who are willing to pay the market price are prohibited from buying it. There is no story in which anything like this situation can come about from the health care reform being debated. Anyone who is willing to pay the price will be able to get any medical services they want, under all the various permutations of health care reform currently being discussed in Congress, just as is the case today.

    The underlying issue here is very simple. The insurance industry, the pharmaceutical industry, the medical supply industry and the A.M.A. are very worried about the threat that health care reform presents to their future income. It would look unseemly for millionaires to get out in front of the public and say that we don't want health care reform because it will jeopardize our income. So, instead, they go into a nonsense rant about rationing.

    If the media were honest and trying to reform the public, they would be running front page stories about this effort to deceive the public. But, the media is actively trying to court these powerful special interests to stay in business, as The Washington Post explicitly demonstrated with its plan for pay-to-play seminars. So, the industry groups know that the media will allow them to pass off utter nonsense as serious argument.

    But, the public should know: When someone talks about health care rationing, they are not being truthful; they are just saying something to try to prevent serious reform. And, when a media outlet reports complaints about rationing without pointing out their absurdity, they are working for the industry groups; they are not being real reporters.

Dean Baker

Dean Baker is a macroeconomist and co-director of the Center for Economic and Policy Research in Washington, DC. He previously worked as a senior economist at the Economic Policy Institute and an assistant professor at Bucknell University. He is a regular Truthout columnist and a member of Truthout's Board of Advisers.

Last modified on Monday, 13 July 2009 11:29