Government rationing of medical services reality in some states

WASHINGTON – As the Obama administration and the Democratic Congress move to provide government-controlled health care on a national level, similar experiments in some states suggest medical care can take a backseat to politics and bureaucratic red tape – resulting in even urgent, life-saving treatments being denied while so-called "preventive services" get priority.

Oregon, for example, has become the first government in the world to draw up a formal procedure for rationing health care, shifting priorities away from life-saving measures to more politically popular treatments, Health Care News reports.

The state health care program for low-income people ranks treatments for various diseases and conditions in order of priority. If a treatment ranks 504 or lower on the scale, no treatment will be authorized.

Some of the ailments that will not be covered include such serious conditions as vocal cord paralysis or deformities in one's upper body and limbs. However, therapy for youthful conduct disorder, pathological gambling, mild depression and mood disorders are covered.

The rationing decisions were made by a government commission after hearing public comment.

"Between 2002 and 2009 there was a fairly radical reordering of priorities," reports Health Care News. "A great many life-saving procedures that ranked high in 2002 have been relegated to much lower positions in 2009, while procedures only tangentially related to life and death have climbed to the top."

In 2002, for example, treatment for severe or moderate head injury, hematoma/edema with loss of consciousness, ranked No. 1 in priority. Seven years later, after a variety of mainly special-interest groups weighed in on the priorities, it fell to No. 101 on the list. Ruptured spleens ranked 13 on the list in 2002, falling to 178 in 2009.

"Similarly, abortion now rank 41st, showing the state considers using public money for abortion more important than treating an ectopic pregnancy (43), gonococcal infections and other sexually transmitted diseases (56) and infections or hemorrhages resulting from miscarriages (68)," reports the publication.

Different scarcity issues affect Medicare patients around the country. In Alaska, for instance, fewer than 20 percent of doctors in Anchorage accept new patients covered by the federal health-care program. According to a 1997 federal law, a physician cannot accept cash for Medicare-covered service unless he or she has been withdrawn from the Medicare program for at least two years.

In 2006, Massachusetts, in a program overseen by then-Gov. Mitt Romney, began mandating "universal health care" by forcing every individual to purchase private health insurance or get into one of several government programs. Already, Massachusetts is unable to bear the costs of its own program, according to John Graham, director of health care studies at the Pacific Research Institute.

Nevertheless, more states continue to establish new health-care bureaucracies – with Utah recently joining the list. Minnesota, meanwhile, is considering extending greater state control over the industry with, among other requirements, mandatory enrollment in medical homes, ending state payments for medical errors and new disincentives for C-section deliveries.