As Ezra Klein points out, the problem with pushing "rationing" as the reason not to reform, is that it ignores the very real fact that we already "ration" healthcare in this country. Don't believe it? Just check the picture for this post. It's a photo of a free clinic in Inglewood, CA this month.
Klein argues, accurately, that pricing healthcare out of the financial reach of 1/4th our population is rationing. He proves his point by citing a 2001 Health Affairs survey:
(It) found that 38 percent of Britons and 27 percent of Canadians reported
waiting four months or more for elective surgery. Among Americans, that number
was only 5 percent. This, Americans will tell you, is the true measure of our
system's performance. We have our problems. But at least we don't sit in some
European purgatory languishing without our treatments. That's rationing.
There is, however, a flip side to that. The very same survey also
looked at cost problems among residents of different countries: 24 percent of
Americans reported that they did not get medical care because of cost.
Twenty-six percent said they didn't fill a prescription. And 22 percent said
they didn't get a test or treatment. In Britain and Canada, only about 6 percent
of respondents reported that costs had limited their access to care.
The numbers are almost mirror images of each other. Twenty-seven
percent of Canadians wait more than four months for treatment, versus only four
percent of Americans. Twenty-four percent of Americans can't afford medical care
at all, versus only 6 percent of Canadians. And the American numbers are
understated because if you can't afford your first appointment, you never learn
you couldn't afford the medicine or test that the doctor would have
As commenter "_SP_" notes about Klein's argument, the survey should really say:
27 percent of Canadians waited more than four months for surgery, 6 percent
waited forever.5 percent of Americans waited more than four months, 24 percent
waited forever.Which would you prefer?