It's interesting that when patients make the decision it's considered sensible but when health coverage won't pay for it it's considered rationing
But this is precisely what it is. Especially with Medicare.
Years ago, HMOs used to play a little game. If they would deny a test, when questioned about possible responsibility if their decision would prove to be wrong, they would answer -- "We are not stopping you from doing the test, we're just declining to pay for it".
And, technically, they were right. I know cases when patients, after denied appeals, agreed to pay out of pocket. With Medicare, it's different. Usually, providers cannot charge them for things which are normally covered - but in their case denied - by Medicare. This represents enforced rationing, all the way.
For as long as patients cannot go outside the system, all those concerns about the way insurers may decide what is covered and what is not - are far from groundless. They could be, quite literally, issues of life and death - decided by bureaucrats holding schematics in their hands. |
