Friday's NYTimes reports Arizona has decided to stop funding certain organ transplants under the state's Medicaid program. According to the article, "lung transplants, liver transplants for hepatitis C patients and some bone marrow and pancreas transplants, which altogether would save the state about $4.5 million a year" were ended in October.
I highly recommend this post from Joe Paduda's Managed Care Matters blog on the State of Arizona's recent decision to stop covering certain medical procedures under Medicaid. His words are grim but well worth considering. It's true -- health care rationing is occuring now based on the patient's ability to pay. How we will ration it in the future, particularly as the federal government implements the Patient Protection and Affordable Care Act over the next several years, is something we as a community of Americans need to discuss.
All goods and services are rationed, normally by the buyer's ability and willingness to pay for them; that's why some folks buy 60-inch flat-screen HDTV's and others don't. The question of whether the U.S. should continue to ration health care services in that way was (and is) at the heart of this country's debate on health care reform. Some see that as the only efficient and objective way to do it, while others see it as unfair and possibly immoral. The first group, distrustful of government power, sees letting market forces ration care as preferable to giving government a larger role. The second group, distrustful of the power exerted by wealthy private interests, believes that government should play a significant part in helping people get the care they need, particularly since many injuries and illnesses are unrelated to behavior (see the recent story in Sports Illustrated about the young athlete in California who died from lung cancer despite never having smoked and having no family history of the disease.) Both sides of the debate make compelling arguments, and neither should be dismissed as "selfish" or "greedy" or "socialistic" or "taking away our freedoms." We need to have this discussion; the sooner, the better.
The first principle of economics is that unlimited wants collide with limited resources. How we resolve that conflict when it comes to health care will speak volumes about our character as a country and our ability to solve our long-term problems with controlling our public debt.
I'd love to hear your thoughts on this in the comments. Please discuss "rationing" in a "rational," civil and polite way. I have limited patience for flame wars. Thanks in advance for understanding.