Health Care Reform and Rationing of Medical Care

Another red herring attack against health care reform is that it will lead to rationed medical treatment. Still another issue is that the reform will put the government between me and my doctor. As these are two sides of the same coin I will deal with them at the same time.

If you consult your medical coverage manual to check if a procedure is covered, you are already under the umbrella of a rationed system. If you have a list of doctors who you can visit under the plan at the full deductable and that list does not cover almost every doctor in the community, you are under already living under a rationed system. If you have to contact your provider for approval of particular procedures before receiving treatment or visiting the specialist, then you are living under a rationed health care system. If there are annual and/or life-time treatment limits in your medical plan (most plans have such a feature), you are living under a rationed system.

All but the most luxurious plans are rationed health care. The plans control which doctors I can visit with the plan covering the fees and what treatment they will cover. When my health care provider requires pre-approval, denies a service and mandates an alternate treatment be explored first a health care bureaucrat, most of whom have no medical training, has come between me and my doctor. Since living in the United States I have had more health care bureaucrats involved in medical decisions than I ever experienced under the Canadian system.

Annually my employer tweaks the medical plan in an effort to control costs. A shifting plan is a reality of the American system. Americans live under one of the most rationed health care systems in the world. The problem is that the average American is totally powerless to impact their design and shape of their health care plan. The decisions are made by the employer and the medical insurance provider as to what will or will not be covered. I could purchase off-system packages, but they are costly and full of loop-holes many of which only become apparent when I need treatment.

The average American would be surprised by the freedom and the quality of care they would experience under the German system, or the Swiss system, or the Italian, or the Japanese or the Canadian systems, all of which have been rated as having a superior system for the average system and at a less cost. In none of those countries are the range and extent of the American pre-approval processes does not exist. In those countries the plan outlines what is covered and what will not be covered, and that list is often more extensive that most American plans.

Then why would Americans strongly defend their existing system while turning a blind eye to the shortcomings of their own system? One reason is the American exceptionalist mindset. Americans, both leaders and the masses, believe that in most areas they have a superior systems and that while the world can learn from them, they have little to learn from others. American pride holds that America is the best in all areas, only grudgingly concede they are not the best in an area only when the volume of data indicates that their “best” position is no longer defensible on that matter.

In 1994 Taiwan decided to overhaul its medical system. Taiwan is a country that looks to copy the United States as much as possible. The Taiwanese initially looked at the American system and started to consult ex-patriots and second generation Taiwanese-Americans who were involved in the American system. The Taiwanese government heard over and over again, do not copy the American system as it is inferior to any other health care system existing in the developed world.