Rationing Still Ever-Present in Health Care Reform Bills

It is good news that the Senate Finance Committee has dropped the “end of life counseling” provision in its yet unseen version of health care reform. H.R. 3200, the House version supported by the Obama administration, still contains this provision.

Even if the House drops “end of life counseling,” there is inherent rationing built into both the House and Senate bills supported by Obama. Here is the National Right to Life Committee’s explanation as to why:

• Unless there is sustainable, adequate financing, over-promising while under-funding health insurance for the uninsured will almost surely lead to rationing when, down the road, government has to face the shortfall.
• The government must not be authorized, whether through “comparative effectiveness” research using “quality adjusted life years” or other measures, to compel or encourage denial of life-saving medical treatment, food, or fluids based on the patient’s age, disability, or “quality of life.”

Both H.R. 3200 and the Kennedy America’s Affordable Health Choices Act allow comparative effectiveness research to be used in making coverage decisions in ways that discriminate by denying or limiting health care based on age, present or predicted disability, or expected length of life. Neither of the bills protects people from use of a QALY, which is a standard that discounts the value of a period of life based on the patient’s present or predicted disability or quality of life.

Bottom line — if you are older or have a disability, these discriminatory standards can be applied to you and deny life-saving treatment that you want.

The average American — particularly those most at risk — understands this just by using their common sense. If there isn’t enough money (and there isn’t) and if the government is setting the standards (and they will), they will get the short end of the diminishing health care dollar. That’s why Americans are angry and scared — and rightly so.

Barbara Lyons