Laura Hershey: Writer, Poet, Activist, Consultant Rotating Header Image

rationing

Putting My U.S. News & World Report Article in Perspective

I had an op-ed essay opposing futile care policies and health care rationing published in the August 2009 issue of U.S. News & World Report. The print magazine hit newsstands several weeks ago, and yesterday it was posted on the magazine’s website.

Shortly after I submitted my essay, I started hearing some Republicans criticizing President Obama’s health care proposals using some similar-sounding concepts. They warned that expanding coverage to more people would result in “rationing,” and specifically the denial of care to elderly and disabled people. Sarah Palin, who seems determined to move on from her unimpressive term as governor of Alaska to another disastrous quest for national office, is advancing such claims. She has suggested that her baby, who has Down syndrome, would be endangered by the President’s plan. Palin said the following:
“the sick, the elderly, and the disabled would suffer the most under such rationing; and that under such a system these ‘unproductive’ members of society could face the prospect of government bureaucrats determining whether they deserve health care.”

Click here to read Palin’s entire diatribe.

This is nonsense.

As the author of what I hoped was a thoughtful, fact-based argument, I want to clarify that my concerns about treatment refusal and related issues do NOT mean I am opposed to health care reform. I do not believe in the specter of “death panels” concocted by Palin and other right-wing obstructionists. Instead, I’m talking about what is already happening, largely as a result of our profit-driven insurance system: Physicians and administrators employed by corporate health plans feel the pressure to maximize company revenues by cutting costs. They inject their own fears into “compassionate” recommendations against treatment, but this occurs in the context of coverage plans where private money interests matter more than the public good.

The arguments put forward by Sarah Palin, and some others, basically amount to, “My family has good insurance, so why should I care what anyone else does or doesn’t have?” I find this outrageous. Around 16 percent of Americans do not have access to health care. A few of these are people who probably don’t really need it — yet — but many of the rest are families with kids, or adults with chronic conditions, for whom the lack of coverage is a real hardship.

I find it especially ironic that some of the politicians who claim to want to ensure that Grandma and Baby Trig receive all necessary health care are the very same politicians who have no problem denying care to 47 million uninsured Americans, including many people disabilities and chronic illnesses. They claim to fear “government-run health care,” implying that it would be inherently evil, or low-quality, or too expensive. In my view, an expansion of government-funded health care could be far more humane and cost-effective than the services currently offered by the major health conglomerates.

I have experience with government health care — not in England or Canada, but right here in Colorado. It’s called Medicaid, and while it’s far from perfect, for many years it has covered my medical and independent living support needs far better than any private insurance policy would have. And it does so at an administrative cost of about 3 percent — much lower than private insurance industry standards.

It’s true that I and other people with disabilities have encountered problems with Medicaid bureaucracy — unfair denials, bungled paperwork, inaccurate information, and so on. But oftentimes, problems can be resolved through individual advocacy or systems advocacy — something you definitely cannot say about the private insurance industry!

Still, we can expect the rumor-slinging to continue and, unfortunately, the fearmongers will continue to exploit people with disabilities in manufacturing their dire warnings. In a recent, rather hilarious example, a conservative US publication wrote that Stephen Hawking would be allowed to die, IF he were British. Of course it turns out that Hawking is both British and alive. Furthermore, he has some very good things to say about the National Health Service.

Click here to read a good article by someone who has read the entire health care reform bill, and analyzed it from the perspective of care for people with disabilities.

Now my perspective is that the current health care reform proposal is not entirely adequate, since it does not address the important issue of long-term care. ADAPT and other advocacy groups have been urging inclusion of the Community Choice Act in health reform. Without this, I think any changes will be far less successful. Click here to get more information about the Community Choice Act.