Healthcare Rationing

Five Points "The inevitable result of socialized medicine is the rationing of healthcare."

uh … what?  This comment reveals a perspective that I fear is more destructive than constructive as we consider options to improve the delivery of healthcare in the United States.

Let's not forget what ration means.  The root word is ratio:

Latin:

ratio -onis f. [a reckoning , account, consideration, calculation]; 'rationem ducere', [to compute]; [any transaction, affair, business; a reason, motive, ground; a plan, scheme, system; reasonableness, method, order; a theory, doctrine, science; the reasoning faculty].

ratiocinatio -onis f. [reasoning; esp. a form of argument , syllogism].

ratiocinativus -a -um [argumentative; syllogistic].

ratiocinator -oris m. [a calculator , accountant].

ratiocinor -ari dep. [to compute , calculate; to argue, infer, conclude].

rationalis -e [reasonable , rational].

rationarium -i n. [a statistical account].

Rationing is all about distributing a limited resource in a reasonable manner.  All countries ration healthcare.  In most countries, the goal is to distribute this resource carefully based on need.  Yes, someone has to decide what tests get done and what tests don't .. and this usually involves some sort of central management.

But in this country, we ration healthcare based on a far less "rational" variable: ability to pay.  The poor and working poor in this country get worse care than the wealthy  .. and of course there are many variations in between.

There is a lot to debate .. but let's not throw stones fro our glass house and denounce healthcare rationing.

One thought on “Healthcare Rationing”

  1. While I agree with you regarding the “rationing/rationalizing” misnomer that pops up a lot in the mainstream press, I have to say that at this point, I’m not even sure willingness to pay can get you good healthcare in this country. Just try to get an OB appointment, no matter how much money you have. I have “gold standard” health insurance and am willing to pay for any extras out of my own pocket, and my own OB couldn’t see me for six weeks — by which point I’d be into my second trimester.

    Sadly, I was also having serious medical difficulties. I felt as though I had the world’s worst chest cold — except I really had a pulmonary embolism. When I coughed up blood, the nurse-practicioner (gatekeeper) I phoned told me it was probably my gums bleeding, and no, I couldn’t have a sooner appointment. The first time my OB actually heard anything about my condition was when I was when my husband called him from the ER to find out if it was safe for me to have an angiogram to diagnose PE (which I am on injectable Heparin for now).

    How much better off would I have been in a walk-in clinic setting, like the one aimed at poor women in my community? I suspect I at least would have gotten seen earlier.

    What irks me is that medical professionals say “Get good prenatal care, start it early.” Fine, I would do it if you’d let me! “Don’t go to the ER unless you talk to your GP first (unless it’s immediately life-threatening).” I did, he won’t answer the phone. From now on, when I feel unsafe, I’m going to the ER. I’m not going to bother to try to be a “good patient” and get in touch with my OB or GP first. Hey, if I’m fine I can read magazines in the waiting room, if I collapse someone will probably take care of me.

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