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October 22, 2010
Bending the Cost Curve with Rationing
The fundamental premise of the government take-over of our health care system was that government would somehow instill price discipline into the market. Somehow greater government involvement in the system would "bend the cost curve," as President Obama likes to say, lowering the cost of health care for all.
This could happen but only in fantasyland. The fact is government never creates price discipline in anything. The Post Office is not more efficient than FedEx and a government health care system will not be more efficient than one based on the free market.
Since the enactment of the law -- the bulk of which won't go into effect until 2014 -- we have seen coverage dropped, claims of "cost savings" debunked, premiums hiked , choices diminished and unfortunately for the sick and seniors, the beginning of a rationing scheme that will deny care and treatment to the sick. Ultimately as the foundational claims for the law begin to collapse, the government will have one tool left to "bend the cost curve" -- rationing and it appears that breast cancer patients will be the guinea pigs.
Let's be honest: good health care is not cheap. Creation of cutting edge treatments and drugs is even more expensive. Americans have the greatest health care system in the world because, in part, they have access to these cures and treatments. But under a government-run system these cures will be denied as patients lives are evaluated on a "cost benefit" scale.
These are not academic theories. Soon after Election Day, the Food and Drug Administration (FDA) will decide whether breast cancer patients will have access to Avastin, a late stage breast cancer treatment that extends the life of patients on average of six months. The FDA is contemplating "de-lableing" the drug which would allow Medicare and private insurance companies to deny coverage for the drug -- not because of the safety of the drug but because of a newly created "risk benefit" standard that opens the door to the price of the drug being considering in the process.
The decision is a door opener to rationing. If the FDA de-labels the drug, breast cancer patients will be forced to mortgage their homes in order to get the drug - just like in Great Britain.
Rationing care is not the American way -- and neither is government run health care. But government health care and rationing are ultimately joined at the hip as the government attempts to the run the health car system within the confines of new budgetary constraints aimed at "bending the cost curve."
Holly Pitt Young is a frequently interviewed expert in Washington, D.C. who focuses on the crossroads between policy and political engagement.
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