Feature

Facing up to the realities of rationing

“As demand increases relative to supply, many doctors are likely to turn away patients whose coverage would pay the lower rates,” said Tyler Cowen in The New York Times.

Tyler Cowen
The New York Times

Uncle Sam is going to ration health care, say opponents of the Affordable Care Act of 2010, better known as “Obamacare,” said Tyler Cowen. What they don’t mention is that well before that legislation was enacted in March, we were on our way to “rationing on a scale that is unprecedented here.”

The problem stems from the different levels of reimbursement paid to physicians from health insurers. Private-insurance plans pay doctors the most, followed by Medicare (for seniors), and then, far behind, Medicaid (for the poor). “As demand increases relative to supply, many doctors are likely to turn away patients whose coverage would pay the lower rates.” It’s already happening to Medicaid beneficiaries, whose publicly funded care is also targeted by cash-strapped states; Arizona recently rationed “transplant coverage for Medicaid patients.” But even Medicare patients are getting the bum’s rush “as doctors increasingly prefer patients with private insurance.”

Without efforts to equalize reimbursement rates, wealthier people will simply “jump the line by paying more,” a situation the Affordable Care Act will only exacerbate by offering subsidies for private insurance.

Recommended

Strong earthquake hits southern Peru
Peru.
shaken up

Strong earthquake hits southern Peru

Fire kills 11 newborn babies in Senegal hospital
Senegal hospital fire
tragedy

Fire kills 11 newborn babies in Senegal hospital

Internal report blames Johnson, senior leadership for lockdown parties
Boris Johnson
partygate

Internal report blames Johnson, senior leadership for lockdown parties

Biden's promise to defend Taiwan
President Biden.
Picture of Harold MaassHarold Maass

Biden's promise to defend Taiwan

Most Popular

'Why are we willing to live with this carnage?'
Uvalde, Texas.
Briefing

'Why are we willing to live with this carnage?'

Uvalde gunman was inside school for an hour as parents urged police to act
Uvalde school memorial
'Go in there! Go in there!'

Uvalde gunman was inside school for an hour as parents urged police to act

O'Rourke confronts Abbott during shooting presser
O'Rourke confronts Abbott.
breaking news

O'Rourke confronts Abbott during shooting presser