Aug 11 2009
“Rationing” Versus “Triage”
I want to emphasize something I noted in a previous post about rationing verses triage. Let’s look at the definition of triage:
In advanced triage, doctors may decide that some seriously injured people should not receive advanced care because they are unlikely to survive. Advanced care will be used on patients with less severe injuries. Because treatment is intentionally withheld from patients with certain injuries, advanced triage has ethical implications. It is used to divert scarce resources away from patients with little chance of survival in order to increase the chances of survival of others who are more likely to survive.
This is the act of picking winners and losers. No matter how you try and couch it, the act of triage is to determine by some formula who lives and who dies. As I noted in the previous posts the President’s advisors are all for triage to save costs:
This system incorporates five principles: youngest-first, prognosis, save the most lives, lottery, and instrumental value. … When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated.
“Attenuated”means withholding expensive treatments, going cheap.
Interestingly enough a lot of people confuse ‘rationing’ with ‘triage’. Rationing is equally divvying up resources so everyone gets same share. Rationing doesn’t pick winners and losers.
Most people think health care is a limited resource. In our nation it is not. It is expensive, but you can get it anywhere, anytime and most times at the highest quality. What Obama wants to do is take the decision from all of us who have the means to buy our health care as we want (even when we select from the options offered by our employers, we are buying the insurance – the company chips in on the premiums). We don’t like the insurance offered, we can switch jobs (and lots of upwardly mobile people do switch jobs to increase salary AND benefits).
What the liberals want to do is remove all that choice and leave us all with no choice. We will not be rationing health care, but as I noted we will fall into the same trap government run health care has hit in the UK.
They now deny services to certain people like smokers and the obese. They can do this because (a) they are the government monopoly and (b) the budgets say they need to cut costs – which is the same as stop paying the costs.
The UK, as I noted below, is even contemplating making universal health care only for the healthy, to keep them healthy. It a cost cutting exercise which belies the whole point of health care – which is to deal with sickness, disease and incidents attacking our health. Is this universal coverage? According to many it is.
We would be lucky if all the liberals were only planning, or all the existing examples of the liberal model were not already well beyond, rationing. At least that way we all would get an equal share. But they are not. They are performing triage and using balance sheets as the excuse to pick their winners and losers.
Under the UK NHS and Obamacare only the strong will survive. They are real life Scrooges, for implementing and proposing plans that call for the reduction in the surplus population we cannot afford to treat by withholding said treatment?
When you consider that this program is really about money, “youngest first” makes perfect sense. The younger you are, the longer you will pay into the system so it makes sense to preserve those payments.
If you have already made most of your payment into the system or are retired and are a net draw on the system, then you will take a spot behind people who have more to offer.
The same would be true with a very young child with a serious disability who would never produce enough into the system to pay for their required treatment. No million dollar procedures for someone who isn’t going to start paying into the system until 20 years or more have elapsed. At least not until the “boomers” are dead.
AJ,
Health care is about more than “end of life decisions.” It is about America’s fundimental self-identity. That is why you are seeing such intense tribal reactions to it.
Sarah Palin has already picked up on this. People who say Gov. Palin is washed up in national politics need to read the paragraphs below very closely and consider that even if the Democrats pass single payer, they have to implement it over the bodies of the elderly, special needs children, and American individualists that Palin speaks for:
http://pajamasmedia.com/blog/sarah-palin-defines-the-health-care-debate/
Sarah Palin rightly sees the debate in philosophical terms. The American people do, too. People are arguing over this and that provision, but the reason there is a depth of feeling on this issue is because people perceive that health care legislation would be a fundamental shift in the nature of what it means to be an American.
President Barack Obama fights for soft European socialism. Governor Sarah Palin fights for free-market American individualism.
and
The Democrats don’t like the answers the American people are giving and thus have upped the rhetoric and resorted to name calling. In the last week, opponents of government-run health care have been compared to Nazis by the speaker of the House. They have also been called “un-American,†“terrorists,†“the mob,†and more. That’s a sign Democrats have lost the philosophical debate.
and
Instead of calling out Sarah Palin, critics need to realize she’s defining the health care debate philosophically. Really, she’s doing the same thing President Barack Obama is doing. It isn’t like he’s been discussing specifics. He’s been trying to convince people that the government can provide more coverage at less cost than the private sector. He’s been trying to convince people that health care is a right. He has not been mentioning the trade-offs people make when giving the government that much power. Sarah Palin is doing that. She is acting as a clear voice in opposition to a powerful government.
Interestingly, the majority of Americans agree with Sarah Palin, not President Obama.
Romney and the rest of the Republican political establishment — by being non-entities — are leaving a clear path to the Republican Presidential nomination for Palin if she chooses to take it.
Romney’s “steadiness and safety” for the big money boys doesn’t men jack S— to the mass of American voters in Republican primaries scared out of their minds over government run health care or issues of American identity.
Once Palin has the nomination locked up, the big money boy’s choice is her or Obama.
A man who cannot be trusted to keep a deal — Just ask the Blue Dog Democrats in Congress about that.
[…] touched on this very issue in a previous post where I noted this is NOT rationing, but the act of advanced triage (yes folks, there is an […]