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No Rationing, Say Experts, But Public Doesn't Hear

Even as the Republican National Committee trotted out a "seniors' healthcare bill of rights" that opposes any reductions in Medicare spending or end-of-life care, several experts polled by the New York Times said they see nothing in the current reform bills that would lead to rationing of care. Meanwhile, a new poll shows that 50 percent of Americans (including 37 percent of Democrats) believe that Medicare cuts will be made in order to cover more non-elderly people.

That survey, conducted by, also found that two-thirds of respondents thought that they would have to wait longer for health services, including surgery, under reform; 50 percent believed that the federal government would be involved in personal health decisions; and 30 percent believed that the government would require the elderly to make decisions about how and when they would die.

The Times' experts said that, rather than rationing, the things to worry about were how the healthcare system would handle the influx of uninsured patients after they gained coverage; the waste of money caused by providing unnecessary and unproven treatments to patients; and the lack of attention in the current reform legislation to the tremendous inefficiencies in the system that are driving up costs. The expert who cited the latter problem, Peter Lee, head of health policy for the Pacific Business Group on Health, pointed out that if it's not solved, "health care is going to break the bank of not the only federal government but of every household in America."

Most Republicans give no sign of being concerned about this crisis and, indeed, have provided no significant alternative to the Democratic proposals. Instead, riding the wave of fear that they have helped instill in senior citizens, they say they aim to "protect Medicare and not cut it in the name of healthcare reform."

The Obama Administration says it doesn't intend to ration care for the elderly, and even the AARP agrees that the current bills do not involve rationing and would not "put the government between patients and their doctors," in the words of AARP Executive Vice President John Rother.

But that does not matter to those who are trying to stir up alarm and mistrust of the reform proposals. All that matters is that enough people believe their misinformation--and as the poll suggests, a large number of Americans do.

What is getting lost in this war of words is the health policy experts' point: We better start dealing with the issues at the root of our healthcare crisis while there's still an opportunity to address them. And at the top of that agenda, as Steven Weinberger of the American College of Physicians recently said, is to figure out how to reduce the amount of misuse and overuse of services by our healthcare industry. If Republicans want to call that rationing, fine. But we already have rationing by ability to pay. Wouldn't it be better if we rationed the things we don't need?

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