There will be rationing

There will be rationing of health care. There is rationing now, for that matter, but we don't usually call it by that name.

Here's Mickey Kaus, from a basically left/Democratic viewpoint, in  "The Real Medicare Divide":

"But the bigger fault line will be the line that is just emerging, between those who want Americans to keep getting whatever health care will make them better–which is more or less Medicare’s current, costly posture–and those who accept some system, whether public or private, that would deny them some treatments because of their expense: the Treaters vs. the Rationers."

He notes, correctly, that President Obama is among the Rationers, and has been obviously so ever since his famous conversation about whether it was a good idea for his grandmother to have hip replacement surgery (which is, in my opinion, a matter worth discussing). I really like, though, Kaus' defense of the Treaters.

And here is Megan McArdle, from a basically right/Libertarian viewpoint, in her post "The GOP Health Plan: A Difference in Kind, not Degree":

"But one thing to keep in mind is that this Medicare plan is not effectively very different from what the Democrats claim ObamaCare is going to do: which is to say, cap the amount of money spent on providing health benefits to those who are not rich enough to opt out of the public system. The Democrats want to do so by having a central committee of experts decide what our health dollars get spent on; the GOP wants to put those decisions into the hands of consumers. But this is not an argument about who loves old, sick people more. Both parties are promising to halt the rapid growth of government health care expenditures, which is definitionally going to fall hardest on old, sick people."

Physicians can do so much more today, compared with what was possible 50-60 years ago. No wonder health care costs more - today doctors can actually do things, like transplant organs and save very, very sick people. Or even just perform routine colonoscopies and other preventive care procedures on almost every patient. None of this was going on 50 years ago.

But though they can perform near-miracles, they still can't perform miracles. And it does seem reasonable to at least have a conversation about where and when and how the rationing will occur, since occur it must.

McArdle:
"Since denying access to health care is really unpopular, it's natural that whenever convenient, both sides will complain that the other is heartlessly (and ham-fistedly) curtailing access to health care. But as the GOP starts to coalesce around block grants and vouchers, it looks like the difference between the models lies less in whether we cut, than in how. The GOP will devolve the decisions as far as possible, while the Democrats will centralize them. That's the debate we should be having, not whether one side or the other are a bunch of heartless bastards who hate sick people."

But still . . .  read Kaus' arguments in favor of the Treaters. Very appealing.