Human Exceptionalism

Obamacare: “All About Rationing”

Harvard Professor and former Reagan economic adviser Martin Feldstein writes today in the Wall Street Journal that Obamacare is “all about rationing. From the column:

The president has emphasized the importance of limiting services to “health care that works.” To identify such care, he provided more than $1 billion in the fiscal stimulus package to jump-start Comparative Effectiveness Research (CER) and to finance a federal CER advisory council to implement that idea. That could morph over time into a cost-control mechanism of the sort proposed by former Sen. Tom Daschle, Mr. Obama’s original choice for White House health czar. Comparative effectiveness could become the vehicle for deciding whether each method of treatment provides enough of an improvement in health care to justify its cost.

In the British national health service, a government agency approves only those expensive treatments that add at least one Quality Adjusted Life Year (QALY) per £30,000 (about $49,685) of additional health-care spending. If a treatment costs more per QALY, the health service will not pay for it. The existence of such a program in the United States would not only deny lifesaving care but would also cast a pall over medical researchers who would fear that government experts might reject their discoveries as “too expensive.”

Exactly. Over time the cost control boards would ration not only “what, ” but also “who,” based on invidious categories such as age, disability, and quality of life judgmentalism.

Feldstein also pushes taxing Cadillac health insurance policies to prevent over consumption.  He mentions a 20% copay is excessive.  I am not sure about that. A lot of us have HMOs with very low copays, and they are hardly Cadillac.  Still, if “too much” private consumption of health care is bad–isn’t it stimulative?–there is no question that government-imposed rationing is worse.  Moreover, why shouldn’t consumers be allowed to have high deductible coverages to reduce insurance expenses?  We do for auto insurance.

These are the things we need the time to ponder and debate.  A lot is at stake.  The last thing we need is a mad rush  to force Obamacare down our collective throats.

Most Popular

Film & TV

A Sad Finale

Spoilers Ahead. Look, I share David’s love of Game of Thrones. But I thought the finale was largely a bust, for failings David mostly acknowledges in passing (but does not allow to dampen his ardor). The problems with the finale were largely the problems of this entire season. Characters that had been ... Read More
Politics & Policy

The Great Misdirection

The House Democrats are frustrated, very frustrated. They’ve gotten themselves entangled in procedural disputes with the Trump administration that no one particularly cares about and that might be litigated for a very long time. A Washington Post report over the weekend spelled out how stymied Democrats ... Read More
World

Australia’s Voters Reject Leftist Ideas

Hell hath no fury greater than left-wingers who lose an election in a surprise upset. Think Brexit in 2016. Think Trump’s victory the same year. Now add Australia. Conservative prime minister Scott Morrison shocked pollsters and pundits alike with his victory on Saturday, and the reaction has been brutal ... Read More
NR Webathon

We’ve Had Bill Barr’s Back

One of the more dismaying features of the national political debate lately is how casually and cynically Attorney General Bill Barr has been smeared. He is routinely compared to Roy Cohn on a cable-TV program that prides itself on assembling the most thoughtful and plugged-in political analysts and ... Read More
Film & TV

Game of Thrones: A Father’s Legacy Endures

Warning! If you don't want to read any spoilers from last night's series finale of Game of Thrones, stop reading. Right now. There is a lot to unpack about the Thrones finale, and I fully understand many of the criticisms I read on Twitter and elsewhere. Yes, the show was compressed. Yes, there were moments ... Read More