Since Insurance Companies Already Ration Care, Shouldn’t It Be Ok If The Gov. Does It?

The short answer is “no.” But Ezra Klein makes that argument pointing out that the vast majority of Americans are already on health care plans that are heavily managed by employers and/or insurance companies.

By last year, only 7 percent of American workers were in “traditional” indemnity health plans, while the rest of us—or at least those of us fortunate enough to have insurance—were swimming in the alphabet soup of HMOs and PPOs and HDHPs.

Mike Adamson on the reader blog comments further:

A common objection to public healthcare is the creation of and intrusion by a bureaucracy into an individual’s plan of care. Why should the government tell me and my doctor what type of care is appropriate? If Klein’s 7% figure is accurate or even in the ballpark, then why would it be better for me to have my healthcare rationed by insurance companies rather than the government?

Obviously, being managed by private companies is better than the government. Because we at least have a chance to opt-out of any given insurance plan.
I don’t have to go with my employer’s health insurance. I could go out on my own and self-insure in various ways, including a health savings account. That many people do choose to be on something like a HMO isn’t exactly an argument in favor of government health care.
The key is choice, and in a gov. health care system there is no choice.
Now, I’ll admit that America’s current way of doing health care is far from perfect. Given the high costs of insurance and health care most people have to have a lot of money to have health care choice. That’s unfortunate. But instead of going to a government system, where we have no choice, we should seek to empower individuals to pay for their own health care so that the net result is more choice.
And we could do that by getting the government to stop its interference in the health care/health insurance markets that are causing so many problems. Like ending insurance mandates, for instance, and essentially subsidizing employer health care by exempting premium payments from taxes.
Ezra Klein seems to think that the solution to rationed care in the private health care market is rationed care in a government health care system. That’s a little foolish. The solution, I think, is creating more choice. And we can do that by having less government in health care, not more.

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  • http://sayanythingblog.com/entry/america_is_back/#c397018 DINO

    No. We should provide new kidneys to 85 year olds, experimental cancer treatment to 90 year olds and perhaps some boob jobs for those saggy 75 year old breasts. Medicare should provide unending treatment for the aged or risk being seen as practicing eugenics.

    If your little kids don’t get care, well, that’s tough. The old people should be kept alive forever.

  • robert108

    It’s also wrong to have insurance companies ration health care; the consumer of the health care should ration his or her use of it; insurance companies are in the private sector, and so through the choice of which insurance company to use, the consumer has some say in the present rationing. Moving to further disenfranchise the consumer is moving in the wrong direction.
    It’s a false equivalence, Rob.

  • Buzz

    First rob said that only the government health care would limit benefits, now he has switched gears being no one bit on that bullshit.

    Your only choice is what level of deductible you want with your employer, if you even have that choice. Going out and getting your own, without the benefit of your employers contribution would be too expensive. You have no choice face it.

  • robert108

    little buzzy: in your ignorance, you prove my point that the only real “reform” in the healthcare industry it to get govt out of it and return it to the free market, where supply can rise to meet the demand, resulting in the lowest possible price with sustained delivery.

  • docdave

    Insurance companies rationing care?? I don’t think so. An insurance company may tell you that they will not cover a certain procedure but that doesn’t stop you from having it on your own dime. Obamacare would limit what healthcare you could get under any circumstance.

  • Bat One

    Both Rob and Mike Adamson are asking the wrong question (Buzz, as usual, can be ignored). The more fundamental question is whether health care services of any sort should be rationed at all.

    Listening to Obama’s rhetoric one would think that the answer is “No!” there should be no rationing of health care, and that everyone should have access to whatever health care they require.

    But the reality is that even if we had not just spent $800 billion we do not have on a so-called “stimulus package” (which hasn’t!), and even if Medicare and Social Security weren’t facing imminent insolvency, and even if the federal Pension Benefit Guarantee Corporation wasn’t similarly teetering on the brink under the weight of huge unfunded pension liabilities, and even if the American taxpayers weren’t already on the hook for some $24 trillion in bailouts, buyouts, guarantees, and assorted financing, and even if the economy wasn’t still headed south and losing jobs and with them tax revenues, even then, we still could not afford to provide everyone with an unlimited supply of health care services as the Left likes to imply.

    What Obama and the Dems are offering is a mirage… an illusion which can never live up to its promise. Service providers and insurance companies currently “ration” care based on what is or has been paid for. Adding tens of millions of more consumers of health care services, with no increase in the supply of providers and facilities, can only make the rationing more acute, as will the presence of the federal government crowding out private providers and insurance plans.

    The Left has never managed to get past the notion that if a large enough group of people want something, the government ought to provide it regardless of the cost. And as usual, those on the Left, Obama included, have no comprehension of how markets work and the economic forces that balance supply and demand of any product or service.

  • robert108

    Bat: Good one! Of course, the basic truth of free enterprise economics is that the rationing is done by price, which is the resultant of the relationship between supply and demand. It is a basic truth of human reality and the physical world that everyone cannot have everything they want all the time. People ration their time and energy every day.
    The good part about having price as a rationing device is that spending is about personal priorities. If one needs medication, one can stop spending one’s money on cigarettes, alcohol and pot, therefore freeing up those funds for the medication or doctor visits. None of us have an infinite supply of money, so we always ration on the basis of personal priorities.
    The promise that taxing and spending by an irresponsible govt can somehow change those realities is the height of folly.
    Even if our economy were growing and prospering, with healthy and self-sustaining growth, not everyone could have everything they want all the time.

  • 11B40

    Greetings:

    In his “The Road to Serfdom”, F.A. Hayek addresses the point of why it is easier for people to accept a bad business deal (private insurance) than a bad government deal (public insurance).

  • Bat One

    DocDave is right!. The “rationing” argument is specious, based on the unspoken premise that health care is something that people shouldn’t have to actually pay for themselves. Its simply another bullshit excuse for extending government control over the lives and the wealth of society’s productive and responsible members for the benefit of those who are neither.

  • Hannitized

    If DocDave is right, then Obamacare is better!!

    An insurance company may tell you that they will not cover a certain procedure but that doesn’t stop you from having it on your own dime.

    And what if you can’t have it on your own dime? You’re dead.

    Sorry, but I rather have them pick my line of care.

  • Hannitized

    Well, that’s the nature of universal healthcare, isn’t it?

    We all pay for the roads, at least those of us lucky enough to be able to afford a car and insurance. Is it fair that poor people pay for your highway????

  • Bat One

    And what if you can’t have it on your own dime? You’re dead.

    Sorry, but I rather have them pick my line of care.

    In other words then, you believe that everyone should have access to whatever health care they want, no matter what the cost, and the rest of us should be obliged to pay for it?

  • Bat One

    … at least those of us lucky enough to be able to afford a car and insurance.

    Witlessly, of course, you are acknowledging that those who are actually using the roads are the ones who pay for them. Not much of an example then, is it?

    Coincidentally, you’ll also find that those who use them most, truckers, pay proportionately more than do the rest of us.

    Now let’s see… pay for what you use, and pay more if you use more. Milton Friedman would be so proud!

  • robert108

    … at least those of us lucky enough to be able to afford a car and insurance.

    It has nothing whatsoever to do with luck; it’s a matter of life choices and dedication to achievement.

  • Bat One

    H,

    If you need help applying the lesson learned from roads to the question of health care, just let me know. I’ll be glad to help you understand how it works!

  • robert108

    dd makes the point that there are degrees of rationing. For a free country, the best form of rationing is done by the individual, making his or her own choices. The next best is something like insurance companies rationing what they will pay for, but not what you can choose to pay for. The worst is totalitarian govt removing all other choices but the ones the bureaucracy makes for you.

  • Bat One

    R108,

    I was getting to that. But we gotta go slowly here so as not to lose him. He is easily put off by that which he does not comprehend… including how life actually works.

  • robert108

    Bat: Leftie ignorance is so broad spectrum, it’s hard to know where to start, so anywhere is fine. We’re a team on this one, IMO.
    I have no faith in little H’s ability to learn, though.

  • Hannitized

    you are acknowledging that those who are actually using the roads are the ones who pay for them. Not much of an example then, is it?

    People who don’t use them pay for them as well.

    WE pay for car insurance, health insurance and don’t have to use them all the time either.

  • Bat One

    WE pay for car insurance, health insurance and don’t have to use them all the time either.

    Take a break. You’re babbling again.

    Roads are paid for with proceeds from the taxes on gas and diesel fuel. Your example, using road construction and maintenance to argue for universal health care, was laughably stupid, since it supports the conservative “pay for what you use” approach.

  • Bat One

    The worst is totalitarian govt removing all other choices but the ones the bureaucracy makes for you.

    R108,

    Which is exactly where we are headed if this “obama-care” monstrosity becomes law.

    I find it curious that none of the lefties can explain how you can add 30 to 40 million consumers of health care services, not add any substantive number of providers (in fact, this will probably reduce the number of providers considerably!) and expect prices to be reduced without government rationing of services.

    One might almost be inclined to think that those on the Left, from Barack Obama on down, simply don’t know shit about economics.

  • JMT

    The old “But Mommmmmy & Dadddddddy the OTHER kids do it!!!” line never worked for us nor on us.

    A 85 yr-old SHOULD get a kidney transplant IF it’s INDEPENDENTLY (meaning W/O govt intervention) determined that the 85 yo can w/stand the surgery & a kidney is available & they’re next on the list according to need & w/in time constraints (if the kidney can get there in time vs getting to another pt elsewhere in time) then YES Dino they should get it. Same w/ your cancer question. IOW, med treatment should NOT be AUTOMATICALLY ruled out just b/c of the pt’s age.

    NOBODY other than for post breast-cancer reconstruction should get “free” implants.

    docdave @ 09:23 am, Exactly.

  • http://insanereindeer.blogspot.com/ Kenny

    And what if you can’t have it on your own dime? You’re dead.
    Sorry, but I rather have them pick my line of care.

    No, you go into debt and make payments on it.

    Or you take charity.

    Of course, no one wants to go into debt to save their lives, and it’s not a premium option…but it IS an option.

    No such option exists under the government care.

    The question is asked, would I prefer a private company or a gov’t make the decision…and the answer is a private company. All they can deny is paying for it, and I can still have it. The gov’t can deny me the service entirely and make sure I can’t get it even if I DO have other options or the money. The private option gives me recourse, where with the gov’t I have none.

    The two aren’t comparable.

  • stewartized

    “Is it fair that poor people pay for your highway”? I don`t know. Is it fair that the “rich” pay for the 40% or so of workers who basically pay no income tax? And of course the “poor” don`t pay for the highway (of course unless they use it), the people who use it the most do. And another- Everbody has the choice not to use the highway but to go some other way.

  • Hannitized

    No, you go into debt and make payments on it.

    Or you take charity.

    Of course, no one wants to go into debt to save their lives, and it’s not a premium option…but it IS an option.

    No such option exists under the government care.

    The question is asked, would I prefer a private company or a gov’t make the decision…and the answer is a private company.

    So you steal from the surgeon and the hospital and make those who pay for insurance pay higher premiums???

    You guys are reaching to the absurd.

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