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".

Obamacare Replacement Act

With all of the media coverage of the failed attempt by the House of Representatives to replace Obamacare you may not have noticed that there is a current bill in the Senate to do just that.  Senate bill 222 was introduced by Senator Rand Paul on January 24, 2017.  A summary of this bill is at this link:

https://www.paul.senate.gov/imo/media/doc/ObamacareReplacementActSections.pdf

The full text of this bill is at this link:

https://www.congress.gov/bill/115th-congress/senate-bill/222/text

ObamaCare-Lite

Michael F. Cannon of The Cato Institute published an article today that evaluates the House of Representatives ObamaCare reform legislation.  The entire article can be read at this link:

https://www.cato.org/blog/house-gop-leaderships-health-care-bill-obamacare-lite-or-worse

Below are some highlights from the conclusion of this article:

The House Republican leadership bill does not replace ObamaCare. It merely applies a new coat of paint to a building that Republicans themselves have already condemned. Since the most important asset health reformers have is unified Republican opposition to ObamaCare, at least in theory, it would set the cause of affordable health care back a decade or more if Republicans end up coalescing around this bill and putting a Republican imprimatur on ObamaCare’s core features. If this is the choice, it would be better if Congress simply did nothing.

Making health care better, more affordable, and more secure requires first repealing all of ObamaCare’s regulations, mandates, subsidies, and taxes. Next, Congress should block-grant the Medicaid program, giving each state a fixed sum of money that does not change from year to year, combined with full flexibility to target those funds to the truly needy.

Finally, and crucially, Congress needs to enact reforms that make health care more affordable, rather than just subsidize unaffordable care. To make health insurance more affordable, Congress should free consumers and employers to purchase health insurance licensed by states other than their own. To drive down health care prices, Congress should expand existing tax-free health savings accounts into “large” HSAs. Large HSAs would be a larger effective tax cut than the Reagan and Bush tax cuts combined, adding $13,000 to the wages of a typical worker with family coverage. Large HSAs would drive down prices by making consumers cost-conscious at every margin, and would reduce the problem of preexisting conditions by freeing consumers to buy portable coverage that stays with them between jobs. Sen. Jeff Flake (R-AZ) and Rep. Dave Brat (R-VA) have introduced legislation to create Large HSAs.