Friday, August 28, 2009

Yes, Virginia, There Are Death Panels in the Health Care Bill

Liberal Ron Rosenbaum makes the case that current health insurance plans have “death panels” (or treatment rationing) and that government health care will have them too:
“Because yes, there is a ‘panel’ in the bill that will ‘evaluate’ the cost effectiveness of various expensive, minimally life-extending treatment decisions — decisions that any health-care program, public or private, may have to make. No, individuals won’t have to stand before it, but individuals will be affected — and sometimes suffer — from its decisions.”

So, what’s the big deal about treatment rationing? Is there a difference between public and private treatment rationing? Rosenbaum hints that government rationing might even be nicer.
"Would government rationing be better? It might be less greed-motivated, but maybe not."

A government health treatment program certainly would be less “greed-motivated” in terms of the patient’s voluntarily paid dollars, but would that mean better care?

Not if you look at the Oregon Health Plan. It is a government entity with no built in “greed” factor. The problem is that no profit means no encouragement to give not only the best treatment but even up-to-date treatment. Oregon Health Plan policies on cancer treatment, for example, are not just years out of date, but a decade and a half out of date. From the Eugene Register-Guard:
“Dr. David Fryefield, medical director of the Willamette Valley Cancer Center in Eugene, said Oregon Health Plan policies haven't kept up with advances in oncology.

“‘The prioritization list and the definitions and tests that are applied are 15 years old and not appropriate in today's practice of oncology,’ Fryefield said. ‘There are so many more targeted therapies that specifically target the cancer and have very few side effects.’”

What Rosenbaum forgets is the punishment factor that goads private insurers to improve but will have no effect on government run health care.

Private insurers and HMO’s need to deliver at least reasonable care or people won’t pay for their service. Who is going to pay premiums for poor care?

That’s the government plan’s problem. Since government health care gets its payment via enforced taxes and public funds rather than voluntary payments, there’s no built in incentive to give top notch care. They get paid whether the care is good, bad or indifferent.

It’s the problem with all monopolies and subsidized enterprises. They don’t have to be better because they don’t have to compete for dollars.

The desire to stay in business and make a profit means that private health care providers and insurers have to please their customers. That’s a pressure to keep up on new methods and developments in treatment and give better and better care.

The punishment factor has other dimensions. Private insurers and HMO's can be sued and can be investigated by state or federal entities. There are no such resources against government itself.

Who would you rather have working on your cancer treatment? Dr. Fryefield or the Oregon Health Plan?

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