“Rationing is alive and well in this country, but the approach we take makes no sense,” she wrote, giving diabetes as an example. Diabetes treatments are expensive, and physicians and insurance companies decide every day whether a patient should take the treatment (physicians) or whether it will be covered (insurance companies). The great limiting factor is whether a patient can actually pay for the diabetes drugs and treatments, according to the article.
Dr. McClanahan references a book that covers healthcare rationing in “the country that does it best — England.” She said the U.S. healthcare system can learn some lessons from their rationing methods:
• Form a large committee of healthcare professionals (patients, hospital administrators, physicians, pharmaceutical reps, device manufacturers, health insurance reps, etc.) who determine what tests and treatments are both cost-effective and beneficial to society.
• Unproven or experimental treatments will only be covered if patients are enrolled in clinical trials.
• Health insurers can sell plans to cover services that are not considered to be cost-effective. “This creates a two-tiered system, but better than no tier that 40 million people experience now,” Dr. McClanahan wrote.
She argues that patients will know what treatments are covered, physicians and hospitals will spend less time on administrative tasks and health insurers will be more likely to pay claims based on the statutes that were agreed upon. “By objective rationing, we can make our country healthier by providing basic care to all and lower cost,” according to the article.
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