For months, media outlets like the New York Times scolded conservatives over their concerns about rationed medical care. Sarah Palin outraged them by referring to “death panels” when the ObamaCare bill wound up containing language enabling “comparative effectiveness” boards as guiding lights for medical care decisions. Last July I wrote about comparative effectiveness, a medical-care rationing system, by asking the question of who says “no” in a government-run medical system. Today, the New York Times gives the same answer I did, conveniently after the passage of ObamaCare:
How can we learn to say no?
The federal government is now starting to build the institutions that will try to reduce the soaring growth of health care costs. There will be a group to compare the effectiveness of different treatments, a so-called Medicare innovation center and a Medicare oversight board that can set payment rates.
But all these groups will face the same basic problem. Deep down, Americans tend to believe that more care is better care. We recoil from efforts to restrict care. …
From an economic perspective, health reform will fail if we can’t sometimes push back against the try-anything instinct. The new agencies will be hounded by accusations of rationing, and Medicare’s long-term budget deficit will grow.
So figuring out how we can say no may be the single toughest and most important task facing the people who will be in charge of carrying out reform. “Being able to say no,” Dr. Alan Garber of Stanford says, “is the heart of the issue.”
David Leonhardt goes on to praise ObamaCare as the start of saying “no” to people who want more health care. That’s an interesting tack for the Times to take, especially after its screeching over the use of “death panels” by critics, which meant exactly the same thing. Now they admit that the “most important task” of the people running the ObamaCare reform is to deny people medical care — under circumstances where a group of elites decide it’s not worth it.
Once again, we have people looking at this from the notion of a shortage, crisis market. If we want to solve the problem of overutilization, which is what ObamaCare purports to do, we’re going about it in exactly the wrong manner. We need to restore pricing signals in order to make consumers aware of the consequences of their decisions, not shield those costs even further by having taxpayers subsidize even more of those costs. That would require getting insurance out of the way of normal, routine medical care and using it only for catastrophic issues, and providing tax-free shelters for medical-care funds controlled by individual consumers.
Instead, we’re slowly turning the entire medical system into an HMO, only this time with Congress and the executive branch running it. It will suck so many resources out of the middle class that only the wealthy will have any real options outside of the government-controlled network in a few years as insurers go broke under Obama’s regime of price-fixing. Once that medical care becomes an entitlement for everyone, no one will have any reason to exercise cost controls, and the comparative effectiveness policies created will wind up becoming the Dr. No of ObamaCare.