Much is being written and discussed during this Presidential election period about health care reform. Barack Obama prefers a government-run version of reform. John McCain prefers a private market reform that would use tax law changes to accomplish nearly-universal coverage...the stated goal of both approaches.
I saw a news report this morning that serves as a great reminder of one of the things we need to be mindful of if we are going to move to government-run health care. Here is that article:
Medco CEO argues for federally mandated end of life care protocols for Medicare patients.
CQ (9/17, Weyl) reports that in a recent speech at the National Press Club, chairman and CEO of Medco Health Inc., David B. Snow Jr., said that "the federal government should set protocols based on medical science to guide Medicare treatment for patients at the end of their lives." Snow elaborated that "30 percent of Medicare spending -- about $130 billion per year -- is spent on patients in the last year of their lives, often when recovery is no longer possible." But, nearly all of that money could be saved by establishing guidelines "of when to forgo further treatment." Snow also proposed "increasing electronic medical coordination, passing tort reform, promoting healthy lifestyles, and encouraging compliance among patients," which would save an estimated "$1 trillion per year, or half of current healthcare spending."
I have written of the "R" word before. Rationing is a very common practice where tax dollars are used to fund health care. I recall the situation recently reported from Oregon where a patient with cancer was not accorded medicines that likely would prolong life, but would be accorded coverage for 'assisted suicide' since that is legal in Oregon.
This isn't intended as a debate on the efficacy of withholding treatment that would extend life. It is intended to provoke some thought about the need for such decisions if we go down the government-run health care road. There will never be enough tax money available. We see that in the debate over a new school building, and in road repair discussions and so on.
When there is not enough money in a government-run health plan, the patient will pay the price. The organizational structure won't be pared down and taxes won't be increased because it is politically unpalatable. The weakest link in this chain is the patient who has no way to fight the decision. A "dispassionate" board who have never met the patient will make "an informed" decision and move on to the next agenda item.
Medicare is government-run healthcare. Medicaid is government-run health care. Between the two programs, more than 50% of the people in the United States already have health care coverage provided by the government.
So, we debate the question all the while that government-run health care grows essentially unchecked. The next step in Wisconsin, by the way, after BadgerCare Plus is to be BadgerCare Connect...if the politicians on the Democrat side of the aisle in Madison have their way.
Incrementalism is alive and well in Wisconsin. It reminds me of the old saw that asks how one eats an elephant? The answer, of course is: one bite at a time.
