06 December 2010

Legal Euthanasia Vs Rationing

This is a discussion that needs attention in the USA. Many refer to this as rationing of our health care, others refer to it as legal euthanasia, and some call it decision by death panels.  Call it what you want, but this is becoming more common as our health care costs continue it rocket upwards.

Where will it end? No one is sure. Even some doctors are beginning to wonder.  Dr. Rob at medrants dot com is writing about it. Bob Doherty at The ACP Advocate Blog also writes about it. Both are very careful as they need to be, but at least they are making us aware of what is going on in the world when dealing with Medical Insurance, Medicare, and Medicaid.

Dr. Rob at medrants dot com quotes from the LA Times dot com about what our senators are talking about – rationing. Every time reduction of health care is mentioned at least they admit that this means health care rationing.

The article in the LA Times states quite accurately (quote) “Both Republicans and Democrats are in denial on this point (about rationing). Republicans pretend that our current system doesn't stop anyone from getting all the care they need. Democrats pretend that efforts to control costs won't limit medical choices and treatment. But most real-world consumers know better: There is no free lunch.” (end quote)

The article makes some other good statements and deserves to be read by all. At lease they lay the problem out and point out where the rationing is coming from – the top down. When congress cuts costs, Medicare and Medicaid, with the insurance industry following suit, decide what they will not cover.

Although I cannot read it, in the November 24 issue of JAMA there is a statement by Drs. Meltzer and Detsky which says (quoting from Bob Doherty), “rationing already takes place in the United States in many ways in health care. Managed care is exactly a form of rationing in which a private insurer determines whether patients should or should not receive services. In addition, private sector rationing injects profit motives into the calculations... It is critical that Americans learn that rationing currently exists and is inevitable and focus their thinking on how its vagaries are best minimized, rather than use the word to instill fear.” (End of quote).

I will agree that using words like “death panels” and “death by budget cuts” creates fear. However, these words are going to appear in the media and must be recognized for what they are. We cannot put our heads in the sand and hope that they will go away. And as more people are denied medical care, these words will be used.

Over the next months as we see how the Affordable Care Act is carried forward, funded or unfunded, we will see a lot more of fear words and probably a larger number of severe rationing decisions. A lot of people are not going to be pleased about this.

This follows when we consider what potentially may happen to our testing supplies if Medicare is not stopped in their proposal to cut our testing supplies for diabetes. This should be considered preventative supplies and should not be limited like Medicare is planning. This is form of rationing we cannot afford.


  1. I wish all insurance companies would realize that Type 2s start out using food as their "drug" for treating their diabetes. If we can't test before a meal how do we know how much "medicine" to use? If we can't test after a meal, how do we know if the "medicine" helped or hurt us?

  2. This is so true unfortunately. Rationing diabetes glucose testing strips is not the way to better health.