We've barely started to discuss the specifics of health insurance reform and already confront a debate among the deaf. Consider the concerns of the Washington Times, which opines:
"Nationalized health care puts bureaucrats - not doctors - in charge of deciding who needs what medical treatment. Rationing is inevitable under these schemes. That's one reason Mr. Obama's universal heath care plans must be stopped."
The Washington Times makes a strong argument that merits a response beyond an acknowledgement that a bureaucrat can also be a doctor or that rationing exists today. No American who isn't rich enough to pay the estate tax is now exempt from such rationing decisions, whether they are made by bureaucrats who work for the government, insurers or employers.
It is also an ignorant or audacious argument, because it fails to acknowledge that America's largest and most successful health insurance program - Medicare - has operated under those rules for years. The population living under such rules is even larger when Medicaid is considered. Such rules are the norm.
The fact is that reformers are merely talking about tweaking rules that already exist, making them a bit more transparent and perhaps somewhat fairer. The inability of either side to acknowledge that this is ultimately only a marginal adjustment of the status quo is creating yet another debate that is basically misleading and needlessly polarizing.
Take bariatric surgery, which controls obesity and is becoming increasingly popular. Only some Medicare beneficiaries are eligible for it, and only then if it is done at selected facilities. If you're a Medicare beneficiary who's only 20 pounds overweight and think it would be helpful to have this surgery done at your local community hospital, Medicare won't pay. The rules are public. Earlier this month, another such National Coverage Determination defined situations when Medicare would pay for a PET scan for a cancer patient.
I certainly don't have the expertise to applaud or challenge such decisions, but think it important to acknowledge that we've been living with them for years. Deciding what's covered when and for whom may strike some as a bad idea, but it is a pillar of today's system, not a half-baked scheme by some dreamy socialists who want to redefine the American dream.