David Leonhardt spends about a 1,000 words in the New York Times banging around the edges of what has to be done by government to cut health care costs. Or, as he calls it “In Medicine, the Power of No”. He wonders if we can every really learn to say “no”. And, of course, he’s talking about saying no to sick people, to patients – denying them care.
From an economic perspective, health reform will fail if we can’t sometimes push back against the try-anything instinct. The new agencies will be hounded by accusations of rationing, and Medicare’s long-term budget deficit will grow.
So figuring out how we can say no may be the single toughest and most important task facing the people who will be in charge of carrying out reform. “Being able to say no,” Dr. Alan Garber of Stanford says, “is the heart of the issue.”
Maybe I’m reading to much into this, but what is being said here is “the new agencies” which will be “in charge of carrying out reform” need to learn to “say no”.
Huh? I thought all this reform was about leaving such decisions about treatment between your doctor and yourself and not those evil, mean insurance companies. Who are these agencies – these “new” agencies – and why are they in they charged with “saying no?” If they’re “new” they’re a creation of the HCR monstrosity and if they have the ability to say “no” aren’t they strangely like the supposed mythical “death panels” Sarah Palin commented on?
Of course any sane person reviewing the claims of those pushing this piece of garbage known as health care reform knew that to drive down costs, rationing and the denial of care was not only possible but absolutely necessary. And, like so many other aspects of this bill, what was promised to gain support is almost the opposite of what was passed in the legislation.
Leonhardt knows where he’s going with his piece, but he is loath to actually say it. So he dances all around it, but if you read carefully you understand that despite all the rigmarole about bringing patients in on the decision and his belief that if they’re informed they’ll choose the least costly methods, he understands that as he says in his title that someone in authority is going to ultimately have to say “no” to make this work. And that pretty much means, much to the chagrin of the left, that Sarah Palin was right.
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