I have to agree with skeptigirl. Health care isn't being rationed. The money that we pay to HMOs is rationed back to us, after they skim some off the top. In the mean time, they put it in the stock market and hope to make more money, and if they don't, you pay more and more next year, never less if the market goes up. If you have extra money to supplement what the HMO will pay for, you can get past the problem, at least sometimes.
There are plenty of issues regarding health care reform that have nothing to do with the manufactured issue of rationing that isn't rationing.
Excessive profits by insurance companies is a BIG issue. Instead of talking about the false issue of rationing, we should be talking about the real issue of excessive profits being made on a service that people need to survive.
Another issue which has contributed to people accepting the falsely framed argument health care is being rationed, is unacceptable practices (or inadequate guidelines/regulations) for the people in charge of deciding what the contracted health care includes. The problem here isn't someone rationing your health care, it's someone deciding what is or is not covered under the contract.
If I'm a general contractor remodeling your house, there may be a number of things that come up that the contract failed to address one way or the other. Someone has to then decide how the contract is going to be interpreted in light of the things that have come up.
With private health care insurers, some unethical greedy bastards got the bright idea they could cheat people by claiming something wasn't covered in the contract that actually was covered. That isn't rationing, that is abusing the trust the customer had that when they signed the contract or when they paid their monthly premiums the insurer would abide by the contract.
The next question is who would do a more efficient job of rationing that money. insurance agencies and HMOs, you or the government?
Maybe you should also be asking who will be more honest and less greedy.
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Another model that works fairly well is to force insurance agencies to not profit on a basic level of care that everybody must buy a policy in. Those who can't afford it can apply for subsidies. Insurance agencies can sell polices covering truly elective procedures, alternative meds and treatments, cosmetic treatments, special care, etc. This model is used in Germany and is very successful.
I think that is an excellent idea making alt med coverage something people pay extra for. I'd even be willing to trade that for making abortion coverage cost extra (as long as there were still options for poor women) if that got the bill passed.
This still doesn't address the dishonest insurance carriers however, who have been denying care that should have been covered so they can increase profits.
What you need is an arbitrator. One who can interpret the contract that spells out what is covered but who doesn't have a vested interest in either side. And you need to cap profits or increase competition.
...I would love to get some kind of care like this. I am teaching part time while I look for a full time faculty position. I am in good enough health that my health insurance is affordable. My wife is doing contract work while finishing her PhD, so she doesn't have employer supplied insurance either. But because the only migraine med that works for her is more expensive than the insurance companies want to pay for, they only offered her a ridiculously expensive policy, even costlier than what she kept under cobra from her last employer, which was a Cadillac plan. It stinks, but we don't have a choice other than to go without and strike out on our own.
Hopefully, that full time position isn't that far off for one of us, but until then, I've sold my soul to the company store.
Just an FYI. I belong to an HMO for my health care. It is a health maintenance organization. It also happens to be a non-profit co-op. I've been a member for over 30 years. And since I am also a health care provider, I do know the care offered by my HMO is good care, it's science based medicine, and I've never felt the care was rationed in any way.
They have a drug formulary meaning only certain drugs are covered. The physicians are involved in adding or subtracting drugs from the formulary. They base their decisions on science based research outcomes. Years ago I needed a drug that wasn't on the formulary. I got it but had to pay full cost for it. But, my doctor also looked into the research after I brought it to his attention. At first he got the HMO to cover the drug for some patients whose problem was worse than mine and eventually the HMO added the drug to the formulary and now it is covered.
The drug was never "rationed". It wasn't covered, then it was covered only for certain conditions, then it was covered. And the HMO made the decisions based on scientific evidence. They didn't cover the drug the minute there was a little evidence the drug was effective. They waited until the evidence was sufficient. It meant some people who could benefit either had to pay themselves or wait for more studies. But it could also have turned out not to be effective.
Paying (or not) for experimental treatments is another area people mistakenly believe health care is rationed to them. If you are desperate whether it is pain or something potentially fatal like cancer, it's really hard to not see denial of care as rationing. But it isn't rationing if it simply isn't covered by the insurance contract you have purchased.
