Rationing Medical Care Proposed to Cut Costs

Article excerpt

Many Americans expressed shocked disbelief when Dr. Jack Kevorkian demonstrated his suicide machine by assisting in the death of Janet Adkins, a victim of Alzheimer's disease. The physician's purpose was to relieve her suffering.

Yet, these same Americans seem unaware that politicians, health care providers and academics are actively proposing similar Orwellian measures, not to relieve suffering but to cut health care costs.

Because the population is aging, Dr. Daniel Callahan, director of the Hastings Center (a medical ethics think tank), has proposed that we limit health care for those people who have lived a ``normal life span.'' He also has proposed that we stop searching for life-extending technology. Dr. Callahan has more than accomplished what he intended: to initiate public discussion of the limits of medical care and medical progress.

But he is not the first to propose rationing of medical care. As the Alexander Consulting Group reports, ``Insurers and medical plan sponsors ration care by choosing what procedures they will reimburse as covered expenses.

``The federal government rations health care in two ways: age and inefficient resource use. Medicare is available mainly to those age 65 or over, but not to the working taxpayers financing the cost. Once an individual is covered under Medicare, the system rations care away from preventive medicine and toward the terminally ill. Nearly half of the Medicare budget is spent on care for people in their last 30 days of life.''

By introducing payment reform, funding ``outcome research'' and introducing controls on how much doctors can increase patient services, Congress is rationing health care. Also, the government denies Medicaid insurance coverage on the basis of income level to millions and covers only about 40 percent of those living on incomes under the federal poverty level.

Oregon began rationing health care in 1987 and is developing a restrictive list of medical services that it will provide. Meanwhile, Alaska, California, Kentucky and Nebraska are investigating rationing plans and the Colorado legislature now has a bill under consideration. …