John Feehery: Speaking Engagements


Who Does the Rationing?

Posted on July 22, 2009

Who Does the Rationing?


            David Hilzenrath of the Washington Post has an interesting article about the health insurance industry in today’s edition, (  The major point of the article was about the fight over the data about support for a public plan, but the kicker of the story had some interesting thoughts about rationing.


As the article states, “Economists generally agree that if costs are to be brought under control, someone must say no to care that doctors propose and patients demand. So far, that role has fallen primarily to insurers." Private insurers have effectively engaged in rationing, so they're doing the dirty work for everybody else," said Jeff D. Emerson, a former health plan chief executive. "It's a thankless job . . . but somebody has to do it or health care will be even more expensive than it is now." Private insurers might be better situated than the government to do the unpopular work of saying no, said Paul B. Ginsburg, president of the Center for Studying Health System Change, because they are less susceptible to political pressure.

Insurers are the one group that everybody loves to hate because they tell people that dirty word that no politician likes to say:  NO.

            Republicans have accused the Democrats of foisting a rationing scheme on the American people through this health care reform. But there is even a more dangerous possibility:  that there would be no rationing.  And that is where the cost argument comes in. 

            If there is rationing, the government can’t afford the additional costs that come with government-run health care.  And with rationing, comes the unpleasant specter of a government bureaucrat telling patients what treatment they can or can’t have.  With rationing also comes long waits for important treatments like surgeries, transplants, etc.

            But without rationing, we have bankruptcy.  Health care costs are skyrocketing, because people are living longer, but are living less healthy lives.  Innovation in health care is a good thing, because it continues to come up with different and better ways to keep people alive.  However, one truth must be confronted:  We can’t keep everybody alive forever. 

            Now, would you rather have the government decide who lives and who dies or would you rather have the freedom of the marketplace (and of individual choice) make those decisions.

            The idea of government making those choices sends a chill down my spine.  That gives way too much power to bureaucrats and politicians.

            Now, that doesn’t make me an apologist for the insurance companies.  They need to be brought to the woodshed.  They don’t live up to their end of the bargain, they unnecessarily push up costs, and worse, they consistently try to screw their customers.

            You know those pages and pages of legal language they get you to sign when you join a plan.  That legal language is all meant to somehow screw you out of coverage.

            If you make your premium payments, you should get the coverage you pay for.  That bargain should be put into simple language, and the insurance companies shouldn’t be allowed to screw around when it comes to paying up.

            So, while I am all for reforming the way the insurance industry does its business, I am against the government taking over the industry wholesale.  I don’t want the government making the rationing decisions.  That is not what America is all about.