Should health care rationing be binary or analog?

Should health care rationing be binary or analog?

Summary: When you put everyone on the same plan those on the best plans lose some benefits. This is analog rationing. When you tie care to employment those without get nothing. This is binary rationing.

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Gov. Deval Patrick, D-Mass.Massachusetts has won a Medicaid waiver to finance its Commonwealth Care plan for another three years, assuring something approaching universal health care in that state.

The state saved 40% on its bill for uncompensated care under the plan, it reported in August, as three-fourths of the state's 650,000 uninsured found some coverage.

Critics call this a bailout. Even so the state is under enormous financial pressure as the recession comes on. (A Republican posted this photo of Massachusetts Gov. Deval Patrick.)

If times stay tough the state may have to redefine what it means by care, rationing what it pays for across all citizens. This is what happens in Europe. Hard times mean less coverage, longer waits, fewer staff.

In contrast to this "analog rationing" the normal American cure is to cut the unemployed off from all but emergency care. I call this "binary rationing." You either have insurance or you don't.

In past recessions binary rationing just transferred the burden to charity hospitals, but many of those are being closed, or are being transformed so they can turn people away.

This gets to the heart of the American health debate at any time. But it becomes more urgent during hard times.

When you put everyone on the same plan those on the best plans lose some benefits. This is analog rationing. When you tie care to employment those without get nothing. This is binary rationing.

So how should health care be rationed?[poll id=27]

Topics: Health, CXO, Enterprise Software, Software, IT Employment

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  • Who pays for healthcare???

    .Who is really paying health insurance aka disease care in America.
    Folks lets check the facts and do the math and you will find it is us the taxpayer paying 100% of it all.
    1. The "Private Sector" as the republicans so fondly call it is "Providing" health insurance but it is us the taxpayer after paying taxes on our wages and purchase the goods and services from those businesses who "Provide" health insurance. Providing employees with health insurance is a business expense and it is build into the price of those goods and services we buy and is also tax deductible and it gives those companies who refuse providing health insurance an unfair advantage because they charge somewhat lower prices and yet reap a higher profit margin.
    2. There are about 14 million federal employees with health insurance paid for by, yes you guessed right, the taxpayer and the same goes for our city, county and state employees of about 45 million people.
    3. Those unfortunate people who have no health insurance due to unemployment or who have jobs with companies that use predatory employment practices and other factors cannot afford seeing doctors as needed and will and do end up in the emergency rooms of our hospitals that are again paid for by the taxpayer.
    4. Medicaid paid for by the taxpayer.
    Well, having said all that i think a redistribution of this existing wealth should suffice to include every man, woman and child.
    aloisonline@...