Conservative Distortions on Health Care Rationing

Information from the news pages of The Wall Street Journal is far better than what is present  in its opinion pages. An editorial today makes a misleading argument as to  How Washington Rations health care. The issue here is Medicare’s recent decision not to cover virtual colonoscopy, which is discussed far better in an article from Forbes.com.

There are arguments both for and against coverage of virtual colonoscopy, which are  discussed more fairly in the article posted by Forbes. The Wall Street Journal, along with several conservative bloggers are misleading in citing this as some sort of proof that health care reform will lead us to terrible rationing which we do not currently have.

The reality is that there are things which Medicare does not cover. There are also many things which private payers either do not cover or throw many obstacles in the way of ordering. As I noted last week, “Medicare beneficiaries are less likely to report not getting needed services” compared to those in private plans.

While Medicare beneficiaries experience less “rationing” than those in private plans, the more serious rationing in this country comes from the  nearly fifty million who are uninsured along a similar number who are so seriously under-insured that they do not receive adequate health care coverage.

Do we give up on health care reform to extend coverage to more people because, at this point in time, Medicare does not cover one procedure? It is ridiculous to say that millions should have no coverage because Medicare does not pay for every procedure in existence at this point in time. Medicare rules also change over time. Although coverage for preventive services such as actual screening colonoscopies has greatly increased, as the system is now structured it is biased towards covering treatment and less towards preventive services such as virtual colonoscopy. Expanding such preventive services is also one of the goals of supporters of health care reform.

There is also a certain  hypocrisy in this argument. Conservatives typically prefer market-based changes which would leave consumers with more of the costs for routine and preventive care, reserving medical coverage for more catastrophic treatment. While there are many flaws in this approach, I would think conservatives should be happy about this decision. The rejected service costs between $300 and $800. People can still obtain the test if they are willing to pay. This is exactly the type of service which conservatives have been arguing all along which should not be covered by Medicare and private health insurance.

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