Kristol Misleads On Rationing

From the January 2 edition of Fox Broadcasting Company's Fox News Sunday:

KRISTOL: The more government takes over healthcare, the more government rationing there will be and the more the government will tell you if you have to have a living will or whether you have to discuss it with your doctor every year or every five years. And that is the argument against Obamacare. [Fox News Sunday, 01/02/10]

Fact: Private Insurance Companies Already Ration Health Care

AMA President Rohack Told Wallace That Health Care Reform Bill Gets Rid Of Some Of The Rationing That Happens Now. On the August 16, 2010 edition of Fox News Sunday, American Medical Association President J. James Rohack noted:

Well, there's a myth that rationing doesn't occur right now. In the United States, if a woman's pregnant and on the individual market tries to get health insurance, that's called a pre-existing condition, and it's not paid for. That's why this bill's important. It gets rid of some of the rationing that's occurring right now. [Fox News Sunday, 08/16/10]

Sebelius Saw Rationing By “Private Insurers” On “A Regular Basis” While Serving As Kansas Insurance Commissioner. During her confirmation hearings, Health and Human Services Secretary Kathleen Sebelius stated, “I, frankly, as insurance commissioner, where I served for eight years, saw [rationing] on a regular basis by private insurers, who often made decisions overruling suggestions that doctors would make for their patients, that they weren't going to be covered. And a lot of what we did in the office of the Kansas Insurance Department was go to bat on behalf of those patients to make sure that the benefits that they had actually paid for were, in fact, ones that were delivered.” [Senate HELP Committee hearing via ThinkProgress.org, 3/31/09]

CNN's Gupta: “I Can Tell You, As A Practicing Physician ... Rationing Does Occur All The Time.” On CNN's Anderson Cooper 360, chief medical correspondent Dr. Sanjay Gupta said:

GUPTA: People always say, is there going to be rationed care? And I can tell you, as a practicing physician, as someone who deals with this on a daily basis, rationing does occur all the time. I mean, I was in the clinic this past week, and in the clinic I get all of this paper work that basically says, justify why you're doing such and such procedure, justify why you're ordering such and such test. And if the justification is inadequate, the answer comes back, well, that's not going to be covered. Which basically is saying that the patient's going to have to pay for it on their own. Which is, in essence, is what rationing is, in so many ways. So it does occur, much to your point, Anderson. [CNN's Anderson Cooper 360, 08/12/09]

Sebelius: “Health Care Providers,” Not “Private Insurers,” Should Make Coverage Decisions. On MSNBC's Hardball, HHS Secretary Sebelius further noted:

SEBELIUS: It's private insurers who often are telling their clients that, “No, you can't get this recommended treatment that the doctor has made”; “No, you can't get this drug”; “No, you're not going to be able to stay in the hospital an extra day”; “No, you're not going to get this because we're concerned about costs.”

So, people who say that, “Oh, this is a terrible idea; this could happen someday in the future,” it's happening every day. But it's really private insurance plans that are making those decisions. What we're hoping to do is change that situation. Private insurance companies should no longer be able to decide who gets health coverage and who doesn't, what kinds of benefits are available. And we want to make sure that it's really health care providers that make those choices in the future. [MSNBC's Hardball, 6/15/09]

Health Care Reform Designed To “End Barriers To Coverage For People With Pre-Existing Medical Conditions.” Discussing the administration's health care reform goals, Sebelius stated that “we must end barriers to coverage for people with pre-existing medical conditions.” She continued: “In Kansas and across the country, I have heard painful stories from families who have been denied basic care or offered insurance at astronomical rates because of a pre-existing condition. Insurance companies should no longer have the right to pick and choose. We will not allow these companies to insure only the healthy and leave the sick to suffer.” [HHS.gov, 5/6/09]

Health Care Law Outlaws The Denial Of Insurance For Children With Pre-Existing Conditions. From the Department of Health and Human Services' healthcare.gov website:

Under the Affordable Care Act, health plans cannot limit or deny benefits or deny coverage for a child younger than age 19 simply because the child has a “pre-existing condition”--that is, a health problem that developed before the child applied to join the plan. [Healthcare.gov, accessed 1/2/11]

Provision In Health Care Law Will Also Outlaw Denial Of Insurance Coverage For Adults On The Basis of Preexisting Conditions. The Department of Health and Human Services notes that in 2014, “insures will be banned from discriminating against adults with pre-existing conditions.” [HHS.gov, 7/1/10]

Insurance Companies Acknowledge That They Already Ration Care. On the July 15 edition of Morning Edition, WellPoint chief medical officer Dr. Sam Nussbaum stated that “where the private sector has been far more effective than government programs is in limiting clinical services to those that are best meeting the needs of patients.” Nussbaum continued, “When we look at advanced imaging, and these -- this is MRI, CAT scan, PET scans -- we know that as much as 30 percent of those procedures are not necessary. And we've been able, over the last several years, to have growth in imaging procedures of between 0 and 5 percent. The government, under CMS, has seen imaging grow 15 to 20 percent a year during the same time interval.” [NPR's Morning Edition, 7/15/09]