HealthCare Rationing is a Reality

It started with HMOs — the rationing of medical care based on cost, and that old corporate stand-by — ROI (return on investment). If you can afford it, you can purchase any kind of medicine, operation or device that may or may not help your condition. No one questions you. However, be poor — or more commonly, middle-class with some sort of employer-provided health plan, and suddenly, you can find yourself in a medical version of Deal or No Deal, keeping what little you have and going with less costly treatment, or going for the whole expensive regimen which could ultimately bankrupt you and your family.

While the CNN article referred to below deals mostly with end-of-life issues, this is an issue that is much larger than that, and can affect whether or not you get the best drug for your heart condition, or a cheaper, less efficient substitute. It even means the difference between your child getting the lighter, waterproof Fiberglas cast on his broken arm, or the cheaper, heavier plaster version. It can mean not being able to remove a painful and troublesome gall bladder because the insurance company only pays if there are stones present. Recently, in reading the book "Marley and Me" I was aghast to find out that pain medication for women in labor is not always considered medically necessary — and that women being treated as "charity cases" don't get the epidurals and other pain meds that women with better insurance get.

I also read recently about a hospital association complaining that its member hospitals were not making their expected profit margins. How any health care facility (with the exception, perhaps, of Beverly Hills plastic surgery clinics) can even be run as a for profit entity offends me. Of course health care workers deserve a living wage just as much as the checker in Wal-Mart. So what is the answer? How can we, as a society, "level the playing field" when it comes to access to health care? I wish I knew. What I do know is that the system we have now doesn't work, and is getting worse.

Read about the high cost of end-of-life care on CNN: http://www.cnn.com/2006/HEALTH/08/15/spending.to.death.ap/index.html