On Fox News Sunday this morning, Chris Wallace asked Peter Orszag about whether a public health care option would not involve rationing. Says Steve Benen, “Orszag set the record straight.”
Fox News’ Chris Wallace asked OMB Director Peter Orszag this morning if the administration will be “rationing” health care by establishing a commission of doctors and medical experts to oversee medical practices. Orszag, thankfully, called this a “canard” and pointed to the status quo.
“The fact of the matter is, right now, politicians and insurance companies are making decisions,” Orszag explained. “We’re saying, we want doctors to be making decisions.”
Wallace said once these physicians start “making decisions,” they’ll be in the business of telling consumers which medical treatments they can and cannot have. So, Orszag turned the question around: “Do you think that politicians are currently rationing care? Or insurance companies are currently rationing care? There are no set of decisions that this commission would have that is not currently resting with either members of Congress or insurance companies.”
Matthew Yglesias gives us a new way to think about rationing:
Thinking about the “rationing” question in health care it’s worth trying to get clear. Sometimes there are shortages of something relative to demand—think of a huge oil shock—and the government decides it wants to impose price controls. That, in turn, leads to shortages. So you can attempt to ameliorate the shortages by rationing. Everyone is only allowed to buy so much gas. During World War II, Great Britain had comprehensive rationing for lots of staple food products—you were only allowed so much sugar, so much tea, so much bacon, etc. That’s rationing.
Now consider something else. If you’re a parent in Montgomery County Maryland, you pay taxes to the county and you get to send your kids to very good public schools. But even though the schools are good, they won’t just do anything you want. Your kid can learn Spanish at government expense, but the taxpayers won’t foot the bill for your kid to learn Burmese. But you don’t normally hear anyone say that the presence of a “public option” for elementary and secondary education involves “rationing” of foreign language instruction. If people have the means and want to arrange private lessons for their children of various kinds nobody is stopping them. And certain forms of this sort of supplemental instruction—Hebrew school in synagogues, Sunday school in churches, piano lessons or Kaplan test prep—are quite common.
Think of it as a shift in consciousness. Shake up the gray matter a bit.
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