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  1. Dave Usher
    July 31, 2009 @ 12:00 am

    Hi Jeremy,

    Yours is a very thoughtful commentary on the health care bill now in Congress and your alternative ideas. I have similar concerns, but as I look down the road with the proposed new system I see rationing as unavoidable:
    Missing in the debate about health care change is the obvious requirement to ration services.

    Adding millions more people to a government system without stringent cost control, including rationing, defies common sense and is a prescription for higher deficits or massive tax increases. Other nations with a government-run system implement rationing in one form or another. Yet, on a personal level, denial of service is a tough pill to swallow.

    Those who contend that ‘health care is a basic human right’ are obliged to answer the question: how much care and at what cost? Of course, the devil is in the details, but I would favor rationing, if I understand how it will applied.

    This mad rush by Congress and the President for massive restructuring is wrong. We deserve a debate that is clear, reasoned and thoughtful. We should understand both the personal and system ramifications of overhauling health care, an industry that accounts for one sixth of our economy, before plunging headlong into it. Clear information for that debate should be coming from our Congressional delegation and the health care industry. But it’s not.

    President Obama recently extracted promises from the hospital industry and the drug companies to save $Billions. We deserve to know how those savings will be accomplished. Will hospitals and doctors choose to earn less? Will they ration procedures, gain speculative efficiencies from electronic health records? If the cost savings are real, I want to know how, where and when.

    Vermonters should understand how restricting services will be accomplished. We don’t even hear the word rationing used because our political leaders and others are afraid to talk about it. Yet, we obviously cannot afford a system of medical care that treats every person for every condition with all possible means regardless of costs.


  2. Jeremy Ryan
    August 2, 2009 @ 12:00 am

    Thank you for your comments Dave! Regarding rationing… I think that this is unavoidable, when you are dealing with products/services that someone must make or be paid for to provide. Whether is provided by the government or the private sector healthcare services will be rationed in some way, it’s unavoidable. The question we must ask ourselves as a society is do we want it rationed by one single body or by many?


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