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EDITORIAL: Rationing away medical care

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President Obama told a rally in Portsmouth, N.H., on Tuesday to ignore the "scare tactics" of opponents to government health care. He denied that his plan would ration care. "You will have not only the care you need, but also the care that right now is being denied to you -- only if we get health care reform," he said. The president's promise of unlimited care at a greatly reduced cost isn't feasible.

To confirm that rationing is inevitable, we only need to consider how the Democrats are proposing to "pay for" the new health care plan. In addition to new taxation, they are considering cutting the already below-cost reimbursement rates that Medicare and Medicaid make to hospitals and doctors. When doctors and hospitals get reimbursed for less than their costs, they lose money. That loss has to be made up somehow, such as through cuts in other areas. Hospitals that lose money may close or let go of personnel to make ends meet. Fewer hospitals, doctors and nurses mean less care.

At the June 24 ABC Health Care Town Hall, one participant asked Mr. Obama: "Outside the medical criteria for prolonging life for somebody who is elderly, is there any consideration that can be given for a certain spirit, a certain joy of living, a quality of life, or is it just a medical cutoff at a certain age?" The president's cold response was: "I don't think that we can make judgments based on people's 'spirit.' ... But what we can do is make sure that at least some of the waste that exists in the system that is not making anyone's mom better, that is loading up on additional tests or additional drugs, that the evidence shows is not necessarily going to improve care. ... Maybe you're better off not having the surgery, but taking the painkiller." In April, Mr. Obama questioned whether the elderly should get hip replacements and warned that it isn't "sustainable." He explained: "The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health-care bill out here."

Democrats are tossing around outlandish numbers to back up Mr. Obama's claims of exorbitant waste in the health care system. New York Rep. Charles B. Rangel, chairman of the powerful House Ways and Means Committee, claimed on Aug. 4, "that there is over $2 trillion worth of waste out there in the health delivery system." That's about 80 percent of our current health care expenditures of $2.4 trillion. Such a huge sum could not be cut out without dramatically affecting the quality of care.

Lawrence H. Summers, the president's chief economic adviser, said that merely eliminating unnecessary surgeries could save "as much as $700 billion a year out of our health care system." That's about 30 percent of total health care spending. There's no way to eliminate that much spending without denying some people the care they think they need.

The health care bill in the House of Representatives proposes the creation of a Center for Comparative Effectiveness Research. This new federal bureaucracy would determine what care is supposedly most effective. Patients and doctors should be the ones deciding what care Americans need -- not bureaucrats or the president.

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