Health rationing by wealth kills about 18,000 annually

Published August 8, 2009 6:00 pm
This is an archived article that was published on sltrib.com in 2009, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

The Tribune 's article on the increased demand for health care that might come from universal health insurance touched on an important but completely ignored issue in health care reform -- the rationing problem.

However, The Trib erred in implying that excessive demand for medical care would be a new problem created by universal insurance. No nation can or ever has fully met the need for health care. It cannot be done. There are not enough providers. There are not enough facilities. There is not enough money. Never was, never will be.

All nations have to ration care one way or another. Our current rationing system is simple and the worst there is. We ration by wealth. If you can't afford it, you don't get care.

Consequently, the lack of health care insurance kills about 18,000 Americans every year. In America, if you have the money, you go to the head of the line for a boob job while someone with a life-threatening real medical problem is killed because boob jobs are using up the resources.

The Trib reported waits of 63 days for a routine physical in places like Kane and Daggett counties. Kane and Daggett don't have much money, so they don't have many doctors. Park City has a lot of money and a lot of doctors.

When I go for my annual physical in Park City, I call the office and say, "I want a physical on a Saturday or Sunday between 10 a.m. and 2 p.m." My waits for that have been three to 14 days. The citizens of Kane and Daggett counties ought to be storming the barricades instead of electing reform refusers to Congress.

Other nations use a rational approach to rationing and kill fewer people by doing it right. Rational rationing is done by moving people to the head of the line who have a treatable life-threatening problem.

Cost benefit is also considered -- fixing a crippled kid comes before adding four months to the life expectancy of a 90-year-old. The process is complex. The NHS (England) recently denied a liver transplant to a 24-year-old drunk with cirrhosis of the liver who refused to stop drinking.

The treatment would have been a waste of resources. He would have killed his new liver like he killed his original, so they let him die so they could spend their resources fixing more worthwhile problems.

This is not cold-blooded. It is a sensible way to provide medical care. Our system is the cold-blooded one -- kill a few people without money so Joan Rivers can get another face lift.

The opponents of reform spread a lot of propaganda about wait time problems in rational medical care systems. The truth is that the only people who have to wait are those desiring elective procedures -- boob jobs to the end of the line. If you have a real medical problem, you get faster care with socialized universal health care than in America.

Because it has a rational medical care system, England spends half as much as we do on medical care and gives better care. The English live longer, they have a lower infant mortality rate, and they have healthier teeth. They can see a doctor on Saturday or Sunday because the government pays a $25,000-a-year bonus to doctors for working weekends. But our "reformers" are not even talking about it.

Keith Baker is a former National Institutes of Health Fellowin Medical Sociology. He lives in Heber City.

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