Monday, August 10, 2020

A glimpse into the future of health care

The link below is for a Mises Institute article about rationing of health care in Pennsylvania during the current Coronavirus pandemic:

Pennsylvania Is Playing Politics with Drug Rationing

The future of healthcare is described by these paragraphs from the above article:

Just as a reminder of the kind of central planners we are dealing with, this is the same Pennsylvania Department of Health that decreed on May 12 that nursing homes "must continue to take new admissions, if appropriate beds are available, and a suspected or confirmed positive for COVID-19 is not a reason to deny admission." Months later, nearly 70 percent of coronavirus fatalities in the state have occurred in nursing homes.

Not being content with causing such a disaster, the state health department has issued guidance on how healthcare facilities should ration the limited supply of the new drug Remdesivir in the event that there are not enough doses to go around, but notes that the guidelines should apply to any scarce form of treatment. While certainly an unpleasant subject to address, it is true that in the face of scarcity the limited supply of Remdesivir or any other treatment will need to be rationed and that some kind of method of choosing will be needed. Scarcity is simply a fact of life that must be dealt with. However, because the distribution of Remdisivir has been taken over by the federal government, which distributes it to state governments, which in turn distribute it to healthcare providers, the process has unavoidably become political.

Putting all the jargon aside, the guideline is very clear about several points. First, it is not considered acceptable to distribute care via a random lottery, or on a first-come-first-served basis. Rather, healthcare providers must take into consideration "community-benefit" when rationing care and the department recommends the use of a weighted lottery system.

As you can see, the example lottery that the health department provides uses three different criteria to determine how a patient’s lottery chance is weighted: membership in a disadvantaged community, being an essential worker, and likelihood of death in the next year.

This is just the beginning.  As healthcare becomes more controlled by the State the more politics will be involved in decisions.  Scarcity is a fact of economic reality that can not be eliminated.  There will always be a need to ration drugs, procedures, equipment, and practitioners.  The rationing should be accomplished based on medical necessity and the attempt to provide the highest quality care to the largest number of patients at the lowest possible cost.  When the State makes the rationing decisions the results will always be subject to politics.  Pennsylvania is providing us with a glimpse into the practices that we will be subjected to under "Medicare for All".

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