Some Rationality on Medical Rationing

Times takes on health care fears again

Last Friday, The New York Times fronted a feature by Kevin Sack about seniors down south who are skeptical about health care reform. That story was accompanied, on the jump, by a short Robert Pear article headlined, “A Basis Is Seen for Some Health Plan Fears Among the Elderly.” CJR pointed out how Pear’s article didn’t deliver on its headline here.

Today, The New York Times fronted another feature by Kevin Sack about seniors down south who are skeptical about health care reform. That story is accompanied, on the jump, by a short Reed Abelson article whose headline— “Policy Experts Call Fear of Medical Rationing Unfounded”—points to a very different conclusion than Pear’s piece.

Abelson writes:

Policy experts say people are rightly concerned about the nation’s health care costs. But they also say there is nothing in the current proposals in Washington to suggest that the country is likely to embark on a system of medical rationing anytime soon.

Those fears, the experts say, seem to stem from talk of a government-run health plan or proposals for government-sponsored research to determine which medical treatments are most effective. But few health policy experts see the likelihood of lawmakers’ [sic] adopting some sort of new system in which government bureaucrats decide whether someone’s grandfather can get his hip replaced or a wife can have her cancer treatment paid for.

Like Pear, Abelson acknowledges that Americans who currently have adequate access to care worry that they might lose it under a program of reform (he focused on Medicare, she on the private insurance market). Unlike Pear, Abelson takes the next step: exploring whether there’s a basis for those concerns. The line about paying for cancer treatment for is especially interesting—it reads as a rebuke to the subject of today’s Sack feature, a man who isn’t a town-hall shouter but still fears that care for his wife, a breast cancer survivor, “would be rationed if the disease returned” after reform is enacted.

Abelson’s piece also provides a useful corrective to widespread fears that increased government involvement will introduce “rationing” to the system for the first time:

And people who worry about the government’s playing such a role may not remember that even now private insurers make decisions “about what is medically necessary and what is not,” said Mike Thompson, a principal in the health care practice of the consulting firm PricewaterhouseCoopers. The private insurers, Mr. Thompson said, might decide that a certain cancer treatment was experimental, for example, and refuse to pay for it.

Interestingly, Abelson does report that one common fear—that providing coverage to the uninsured will mean longer wait times for doctor appointments, at least at first—is taken seriously by experts. And to be sure, her brief story, in which four people are quoted, is far from the last word on the issue. There’s an important distinction, after all, between “Policy Experts Call Fear of Medical Rationing Unfounded” and “Fear of Medical Rationing is Unfounded.” Expertise comes with its own set of problems, including groupthink or systematic bias. Experts may not have the same values or priorities of other people, and they may not share an ordinary person’s view of what constitutes “rationing.”

But what experts have that other people lack is information about a particular topic—that’s what makes them experts! And one of journalism’s most important tasks is getting that information to the rest of us. In that respect, this story succeeds.

Has America ever needed a media watchdog more than now? Help us by joining CJR today.

Greg Marx is an associate editor at CJR. Follow him on Twitter @gregamarx.