Rationing Health Care

David Leonhardt has a succinct well-argued column in today's New York Times demonstrating that the upcoming debate about health care rationing is based on false premises. He points out that all societies make choices about where to expend resources - and that even in the US where we spend huge amounts of health care, there are three types of rationing.

1) We spend money on health care, and are unable to spend it on other needs or desires

2) 15% of our population is uninsured, and those people get less and worse care

3)We under-reimburse some types of health care, so they are less available. He mentions after-hours primary care and coordination of physicians in complex cases. I immediately think about how difficult it is to find a child psychiatrist.

Later today, a bipartisan group of ex-legislators (Tom Daschle, Bob Dole and George Mitchell) will release its health care reform proposal.

By the way, Obama's speech to the AMA yesterday has led to much discussion of the impact of malpractice on health care costs. See some background from this past fall at this link.