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Name:
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Yankee06
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Subject:
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Rationing?
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Date:
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9/6/2009 11:53:31 PM
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JAG,
-Based on your comment above, I went back and reread the article at teh top of this thread on Health Insurance companies rejecting claims. I'm not sure if that's the article you were refering to, because I don't see that article to be about rationing. To me that article is primarilly about an industry that doesn't want to do what it promised to do.
-These companies have actuaries that develop "odds" that say something like if the company insures 100 people, one of those people will eventually need X body part fixed at Y cost. To cover that possibility and cost, the company has to charge teh 100 people Z amount of premiums to pay for teh future body part as well as the overhead to run the company. That is the basic XYZs of teh insurance industry. If teh company doesn't have the money to pay out when the time comes, it means: 1) the actuaries suck and should be fired, 2) the managers suck and should be fired, 3) teh managers are crooks and should be jailed, or 4) some combination of teh above. ...but it's not about rationing.
-Rationing is about supply and demand, ..or better put, ..rationing results with the unavailability of supply to keep up with demand.
-Since I have an artificial hip, I always like that example. I've written about my experience in detail in the past, so I won't bore anyone again with alot of detail. Simply put, ....
---British Health Care Panels (Socialized medicine-you pick a country, all the examples will be about the same) have set aside a certain amount of money for new hips and have set up a scale of acceptabilty for receiving those hips (old people are at the end of this list with a wait of several years, which means never). Thus if there are 100 hips available but 200 people who need them, the first 100 get them. the next 100 don't . that's rationing ---in this case, politically determined by the state health commissions.
---In the US there are more hips available than there are people who need them. ..thus there is no need for rationing. Following is a perfect example and it really happened, my 90 year old mother-in-law fell and broke her hip two weeks ago, she was immediately taken to a hospital, a doctor was called in, and three hours later she had a new hip. The bills will be sent to medicare and her secondary insurance carrier. No rationing. She has her hip. If a month from now her secondary insurer says it won't pay,, that becomes a legal matter, ---but it is not health care rationing, --she's got the hip.
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------NOw back to your question (without reference to the insurance company article), do we have heathcare rationing in the U.S.? I think the answer is "yes." ---and "No." First, in one way It's rationed by money or the ability to pay. If you have insurance or can pay out of pocket you get it. If you don't have insurance or can't pay out of pocket you don't get it, ---or at least you don't get it right away. If you can't pay, you get Medicaid, certain Social Security Programs, certain free clinic programs, Emergency Rooms, etc. So quality, or at least speed of quality service, seems to be rationed by ability to pay. But the supply of health care is there and everyone seems to get it eventually, so I guess it's speed of delivery that is rationed by abilty to pay, but eventual delievery of service occurs in most cases , so health care is really not rationed.
--of course heart replacements, liver replacements etc are rationed by supply and demand, because at the moment there doesn't seem to be a way we can manufacture new livers, etc. BUt that is not a political rationing, that is a source product scarcity rationing. We're still working on artificial hearts, so maybe some day we....
-So even if Health care is rationed some way by ability to pay (i.e., speed of providing), health care is not rationed in the way other commodities are; it is a much more compassionate rationing.. For example, if you don't have teh money to buy a new car, you don't get the new car. --at least for the time being you can't go to a government agency and plead your caes for a free new car.
-As I have said before, I believe the real need is fixing teh insurance industry, so that they can't drop you when you get sick, that you still have coverage between jobs, etc. The big crime here is hard working people who go bankrupt because thier insurance won't pay up and they can't get medicaid until all their life savings are spent.
-I believe we need serious, bipartisan, focused reform (insurance, tort, med schools, univrsal coverage), --I don't believe we need socialized medicine. ---but then again, maybe that's just me
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