Cutting health care costs will be expensive

Published 3:49 am Monday, May 18, 2009

By By Tray Smith
Most partisan differences can be explained by the two very divergent ideologies that control our political parties. One says the government should be as small as possible; the other says it has a responsibility to help its citizens get by. This very significant disagreement, however, does not begin to fully encapsulate the coming debate over health care, which will affect the deepest and most personal decisions any of us ever have to make.
I formed my opposition to universal health care for many of the same reasons I oppose most liberal ideas. I saw it as giving something to people who have not earned their own care at the cost of working people who have. That basic premise remains true. However, the perverse economic incentives that will result from extending health care to everyone pale in comparison to the severe consequences that will result from allowing the government to aggressively contain health care spending.
When asked about the hip replacement his terminally ill grandmother received a few weeks before she died, President Obama said he “would have paid out of pocket for that hip replacement, just because she’s my grandmother.” But then, he added that, “whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model is a very difficult question.”
The president was right. Whether a terminally ill patient should receive such expensive treatment is a very difficult question. That is precisely why “society” should not be a part of the decision making equation, as the president suggested. Choices as tragic as end-of-life care issues should be made only by a patient and the patient’s family.
Telling a dying family member to spend the last few weeks of life in bed because a hip replacement would be too expensive is difficult to imagine. Imagining a government that injects itself so deeply into medical decisions it rations care in such cruel ways is even worse.
Yet, that is precisely what the president and his allies in Congress are attempting to do. They already distrust an individual’s capacity to make rational decisions, hence their lack of concern for exorbitant tax and spending rates that deny people the right to allocate their own wealth. This distrust is especially prevalent when health care issues are involved, because the emotionally charged nature of such decisions makes individuals especially prone to irrational judgments. Thus, having the government step in and make those determinations is seen by liberals as the only logical way to keep people from making “illogical” choices, like buying a hip replacement for their dying grandmother.
So, they have proposed elaborate schemes for providing universal health insurance, to both expand the reach of coverage and contain the cost. There actual goal, though, is influencing the toughest decisions any of us will ever have to make. As soon as they succeed, there will be no area off limits to government intervention.
When conservatives defeated the Clinton health care plan in 1994, they warned that if enacted, the bill would inevitably lead to rationing. The government would run out of resources, look to reduce cost, and end up restricting options. Fifteen years later, Democrats are openly touting government rationing as a reason for their health care plan, because of its cost-cutting potential.
What we cut in cost will be lost in benefits. One of the reasons life expectancy has soared so high over the past half century is because of our willingness to always push the limits of modern medicine to keep people alive. When we stop to do that, and tell patients that, essentially, they have passed the benchmark at which it becomes economically unfeasible to care for them, life expectancy will stagnate. The quality of life for those patients will plummet. Most disturbingly, we will have put a financial value on the length of human life. Human life, a commodity long regarded as priceless.
That is the bottom line.
Tray Smith is a former page in the U.S. House of Representatives. He can be reached at His column appears weekly.

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