August 18th, 2009
04:45 PM ET
5 years ago

CNN Truth Squad: Is health care rationing in the cards?

The Statement:
Jason Rogers of San Antonio, Texas: "Four years ago my father was diagnosed with terminal brain cancer. After 18 months, we fought that disease with everything we had. Under a public option or government-run health care system, would that type of care be possible? Is it something that 10 years from now we're going to have to sacrifice or come up with a tremendous amount of cash to pay for it because it would be rationed under our government-run health care system?"

Get the facts and the verdict after the jump:

The Facts:
There is no explicit reference in any version of the legislation to rationing health care and the White House said it doesn't intend to institute a rationing policy. "There are a number of different bills making their way through Congress right now, but we do know this: The reform bill that the president signs will not lead to rationing. It will be fully paid for and it will bring down costs over the long term," the White House said.

But despite the administration's intent, some skeptics believe costs could rise and that shortfalls would create the environment for rationing.

The Cato Institute, a public policy research center, said in a report in June that when Medicare Part A was launched in 1965, the government estimated it would cost about $9 billion per year. But Cato said that by 1990, the cost was closer to $67 billion.

It also said that when the Massachusetts Commonwealth Care was put into place in 2006, it was expected to cost about $725 million annually, but the expected cost for 2009 is almost $1 billion. But Massachusetts officials dispute the Cato figures, saying that the program actually will have cost about $800 million for the 2009 fiscal year when all claims are processed.

"The Congressional Budget Office estimates that existing government health programs would require income-tax rates to rise as high as 66 percent by mid-century," said Michael F. Cannon, Cato's director of health policy studies. "President Obama's new entitlements would require even higher taxes. American voters will not tolerate tax rates that high. Since the government will be the only entity with any incentive to control costs - patients and health-care providers will all be spending other people's money - the government will have to ration care."

President Barack Obama on August 14 spoke at a town hall meeting in Belgrade, Montana, where he raised the issue of rationing in discussing the elimination of "waste and inefficiencies" in Medicare.

"So what we've proposed is not to reduce benefits - benefits on Medicare would stay the same - it's not to ration. What we are asking is that we eliminate some of the practices that aren't making people healthier."

Speaking on August 15 at a town hall meeting in Grand Junction, Colorado, Obama shot back at the claims by some opponents of reform that the administration is trying to ration care.

"Well, that's what's going on right now," Obama said about rationing and restrictions. "It's just that the decisions are being made by the insurance companies."

The White House's health-care reform reality check Web page says reform will stop rationing, not increase it.

Kavita Patel - who works with White House Senior Advisor Valerie Jarrett and worked as a physician - says on that page that the administration wants to combat rationing by insurance companies.

"We want to make sure that people with pre-existing conditions are not denied coverage," she says. "That happens - right now, as we speak. People get kicked out of their insurance plans because they have increased medical costs and they're deemed to be unworthy of coverage. We need to make sure that those people, people like you and me, also have access in case we do get sick, and in case we do lose our jobs, and in case we do need to change from one employer to another."

Verdict:
In dispute. The Obama administration doesn't intend to ration health care, but critics fear that high costs could set the stage for rationing.


Filed under: Health care fact check
soundoff (61 Responses)
  1. john

    Your verdict is a big logic fallacy. What the WH or the critics say doesn't relate to actual truth.

    The information should come from the current bills that are in congress and in the house.

    August 18, 2009 05:13 pm at 5:13 pm |
  2. Trade Freedom for Security, Lose Both

    Hmm...let's do the math...doctor shortage + nurse shortage + 49 million new people in health care system = rationing

    August 18, 2009 05:14 pm at 5:14 pm |
  3. David in SanDiego

    My brother-in-law had three stents put in to open clogged arteries. He was in no condition for them to do the fourth one at that time, so they tried medication to see if it will open the fourth artery enough. To decide whether he needs a fourth stent vs. the medicine (much less expensive) had worked, his cardiologist wanted another Thalium stress test. HIS INSURANCE WON'T ALLOW IT, but they will pay for a fourth stent, which he might not need and which is an invasive procedure. WAKE UP TALK RADIO SHEEP–your insurance provider is rationing treatments right now. At least with a public option, there would be no profit in denying sick people the tests and procedures they need.

    August 18, 2009 05:16 pm at 5:16 pm |
  4. Mississippi Mike

    If we add 50 million new people to the current health care system, rationing will occur. Health care providers are stretched thin as it is, they can't handle a 20% increase in customers. Also, if the government caps health care provider pay and creates a massive bureaucracy for them to navigate (which is what the government always does) fewer people will be attracted to the industry. If there is s a big push to hire new health care providers, standards will have to be lowered and we will end up with a far worse industry than we already have.

    We live in a world of scarce resources where everything is naturally "rationed" based on who can afford those resources. If you want health insurance, you have to pay for it. If you want something not covered by insurance or if you don't have insurance, you have to pay out of pocket. If nobody has to pay anything for health care, someone in the government is going to make the rationing decisions and they are going to use criteria that will have a negative impact on one group or another.

    This is economics my friends, there's no way to increase the number of customers without lowing quality and/or rationing.

    August 18, 2009 05:17 pm at 5:17 pm |
  5. Karen

    We have rationing now – it's called exclusion, recission, and denial of coverage/benefits. When 100,000 Americans die because of a lack of health care, or no access to the system at all, that's called rationing.

    There is nothing about a public option that would ration care. It's just more scare tactics, like "death panels" and "pulling the plug on gramma" that we're hearing so much of from those who oppose ANYTHING Obama, including a health care system that would be affordable and available to millions who have no access right now ...

    A public option is a no brainer, and unless one is included in any bill presented to Obama, we won't have reform at all. Health care costs for the average family have doubled in the last decade, and are set to double again, while people continue to lose their jobs and salaries have been stagnant since 2001. If we don't get a public option, and the system is left in the hands of private for profit insurance companies, Americans haven't begun to see just how bad things will get, and they're bad now ...

    August 18, 2009 05:17 pm at 5:17 pm |
  6. Jay

    The present system is de facto rationing care – people fail to get the care they deserve all of the time and purely at the whims of the insurance companies that only want healthy people for coverage. The only solution to this is a public option where the people and the government have a say in how decisions are made. Lower cost, everyone covered, and we as the people get some say through our elected officials. Ultimately the only sensible way to is to have a single payer system.

    August 18, 2009 05:18 pm at 5:18 pm |
  7. JKT

    It remains unbelievable to me that the parts of the healthcare bill so many people fear are ALREADY IN PLACE:
    "I fear death panels." You already receive no guidance how to manage your estate and make informed choices about which life-prolonging options might be best for you. And if you think there aren't regular meetings at insurance companies about how to optimize profits and pay for as little deathbed treatment as possible, you're living in fantasy land.
    "I fear I'll be allowed to go blind." If your disease isn't on your insurer's list of approved diseases, they'll let you go blind NOW.
    "I fear my care will be rationed." It's rationed now–stories of "preexisting conditions" or "unproven treatments" going unpaid have been rampant in our current system for decades.
    "I fear I won't be able to choose my doctor." Again, already happening now. If your doctor and/or specialist isn't in your "network", you can't see them or have to pay full price to see them (ie. no coverage.)
    What part of ALL YOUR FEARS ARE ALREADY HAPPENING don't you all understand?!?

    August 18, 2009 05:19 pm at 5:19 pm |
  8. Paul

    Someone really missed the meaning of "Fact Sheet". There are no facts on any of the bills here: only, he said, she said and rhetoric.

    August 18, 2009 05:20 pm at 5:20 pm |
  9. E

    The other countries with actual universal health care pay LESS of their GDP on healthcare than teh US and have HIGHER rated care.

    Health care should NOT be for profit!!!

    August 18, 2009 05:20 pm at 5:20 pm |
  10. mary

    They say rationaling is going on now. I have to pay for health insurance, an illegal gets it for free. I pay my weekly deduction from my job, plus a co-payment. Medicare use to be better when my grandparents had it now it does not pay for much. Is this what I am look forward to.

    August 18, 2009 05:21 pm at 5:21 pm |
  11. lila

    How about only people who make less than $75,000 can buy into the public option. that will keep a great number of corporations from switch over. It will also take care of those that need the most help. The rich will not feel so threatened if there is a clear class line. The rich like class lines. The public option will be for those that can't afford private insurance. Kind of like public school vs private school. Public school might have problems but I'm so thankful that we have it. i think in the end, public health care will be in the same category. Public school is a world better than no school. Public health care option will be a world better than no health care. Let those who have more get the very best. They do anyway. Let those who get nothing have something. At this point it's the lower middle class that have no real options. The very poor get government help. The higher middle class have corporate jobs that insure them. Let those that make between $25,000 to $75,000 have the option to receive health care every bit as good as medicare. It will stop the emergency rooms from being flooded with non-emergency health problems, like mild flu discomfort, so people with serious emergency issues can be seen a lot faster. That's a win-win for everyone.

    August 18, 2009 05:24 pm at 5:24 pm |
  12. donttreadonme

    Obama has stated that the Public Option while preferred by him is not necessary and is only a small sliver of reform.

    Get over yourselves liberals!

    August 18, 2009 05:24 pm at 5:24 pm |
  13. Kevin B

    Under our current system, excluding 30 to 40 million americans from health care is the ultimate in rationing, this of course is being done by the for profit insurance companies.

    Only the willfully ignorant or hyper-partisan republicans, would believe that rationing isn't occuring in america at this very moment, every day, all day and has been for decades.

    August 18, 2009 05:26 pm at 5:26 pm |
  14. Steve in Kentucky

    As if the insurance industry doesn't "ration" health care right now. That's why we're trying to have this debate. There's too much health insurance "rationing" of health care.

    August 18, 2009 05:26 pm at 5:26 pm |
  15. Linda Feldman

    Having just gone through 4 months of trying to save my 96-year-old mother's life, I want to add one point to the rationing discussion. Why is it that we think government (Medicare) should pay the millions of dollars needed to keep someone alive? How many families would pay the medical bills? Call it rationing or something else but there does come a point where buying time makes no sense. The patient suffers. The family suffers. There is no peace.

    August 18, 2009 05:27 pm at 5:27 pm |
  16. Rob

    If it becomes a single payer public option, rationing WILL happen.

    August 18, 2009 05:27 pm at 5:27 pm |
  17. DianeR PC FL

    Health care rationing goes on right now. It's only available to those over 65 (soon tobe 66), for the very young (in some states), those whose employers provide it (at what cost to the wage-earner no one knows or will say) the very wealthy and elected officials. Further, health insurance companies are rationing everyday by denying coverage to people all the time; whether its refusing to insure them or refusing to cover critical illness. To ask if health care rationing is in the cards is like questioning reality.

    August 18, 2009 05:27 pm at 5:27 pm |
  18. Kevin B

    Only the willfully ignorant or mindlessly hyper-partisan republicans, would believe that rationing isn't occuring in america at this very moment, every day, all day and has been for decades by the for profit health insurance companies.

    Just ask anyone who has recently lost thier job or has a pre-existing condition.

    August 18, 2009 05:28 pm at 5:28 pm |
  19. Chris C

    Simple logic shows rationing will happen. Start with a low supply of doctors and specialists. Add millions and millions of people to the demand. The end result is clearly rationing. Are we somehow going to have a ton more doctors? Are we going to increase the number of hours in a day? No. Rationing will happen if you increase demand but not supply. You can not argue against this VERY basic principle.

    Remember when McCain talked about reforming Medicare? Remember Obama and the left spreading fear that he was taking benefits away? Shoe is on the other foot now isn't it?

    August 18, 2009 05:30 pm at 5:30 pm |
  20. donttreadonme

    Obama has stated that the Public Option while preferred by him is not necessary and is only a small sliver of reform.

    August 18, 2009 05:32 pm at 5:32 pm |
  21. Sniffit

    This pretend issue about rationing is completely ridiculous. What do you think insurance companies do? Has the entirety of America gone completely retarded? Moreover, HMOs and PPOs were invented specifically for the purpose of increasing the ability to ration on the theory that it wasn't the cost itself, it was the cost generated by excessive service that needed to be kept down.

    The only thing that seems to be coming from opponents of the public option is flatulently false propaganda. No, you do NOT have to lose an eye to get the other treated. No, "illegals" (god what a wonderful racial slur you guys invented there) will NOT be covered. No, death panels do NOT exist in the current draft bill and nothing even remotely close to that does either. No, the draft does NOT pay for elective abortions. No, the draft bill does NOT mandate euthanasia ro pay for assisted suicide. ALL LIES FROM THE GOP, BUT ALL WE GET FROM THE MEDIA IS A STERILIZED PARAGRAPH EXPLAINING THESE THING ARE FALSE...INSTEAD OF PROPER OUTRAGE AT THE PURPOSEFUL UNDERMINING OF DEMOCRACY THRU MISINFORMATION..

    August 18, 2009 05:32 pm at 5:32 pm |
  22. Wisconsin Freddy

    By all accounts, the current approach to health care will escalate in cost to the point where it will be unaffordable. Rationing may be inevitable regardless of the actions taken during this reform initiative.
    We currently have rationing in the form of uninsured and underinsuranced individuals who must make choices to forgo care. Whether free enterprise, government or individuals make the decisions, our health care system rations care every day for many citizens.

    August 18, 2009 05:33 pm at 5:33 pm |
  23. yuri

    These are the types of rumors floated by those thugs who revel in carryin' firearms and by those jokers who have nothing better to do except spreading whoppers and big fibs.

    August 18, 2009 05:34 pm at 5:34 pm |
  24. Thinker

    My understanding is that the government program is NOT created to eliminate the current insurance programs. My understanding is that for the present at least, the program is supposed to supplement the private insurance programs that exist currently. The government programs can be accessed by people who would otherwise not be able to afford any insurance at all. Those who can afford to keep their private insurances, can continue to do so. If that is actually the case, I do not understand what the issues are. Why are people who can afford private insurances opposed to others who cannot do so, get government run insurances? If this is not the case, then I may have to re-evaluate my thoughts.

    August 18, 2009 05:35 pm at 5:35 pm |
  25. donttreadonme

    If you can't afford Healtcare now how on earth will you be able to afford to pay for a Public Option that costs more?

    I get you think you won't have to pay for it? Silly libs even the Public Option is not free!

    August 18, 2009 05:36 pm at 5:36 pm |
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