It is often said that a single payer health care system in the United States would result in rationing of health care. It’s as if people don’t recognize that some form of rationing of health care exists in every country.
In countries that have universal health care systems, all people are able to receive emergency and acute care. Elective care may require a wait, but everyone will get the care they need.
In the United States, rationing is haphazard, based on ability to pay for care and there is NO guarantee that people will get the care they need. In fact, the United States ranks highest of wealthy nations for preventable deaths.
A new opinion piece by the editor of the Journal of the American Medical Association explains that rationing in the United States worsens as the costs of care rise. He argues that as new treatments are developed, only those who can afford them will receive the benefit. He states that we need a national conversation about whether this is acceptable or not and makes an important case for national improved Medicare for all, which is the most effective way to reduce our bloated administrative costs and free up more of our healthcare dollars for care.
The flip side is also true, there is no such thing as unlimited health care, as some are saying when they argue that covering everyone will lead to exorbitant increases in healthcare spending. The system can only provide as much care as it has the resources to deliver. What we will experience is a shift in utilization of services such that those who have unmet health needs will receive care and those who can wait or are currently receiving too much, will be a lower priority. This is the beauty of a healthcare system designed on the basis of improving health – decisions are made in a rational way to improve health.
We have the wealth and resources in the United States to meet our healthcare needs, we just need a system, national improved Medicare for all, that allows us to do that.