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Monday, September 14, 2009


Over the weekend tens of thousands gathered in Washington D.C. to voice opposition to the proposed Health Care Restructuring Plans. At the same time, President Obama at a rally in Minnesota again reiterated that he is not dissuaded from moving forward -- while at the same time presenting no credible source of financing this new health care promise.

This morning, a USA Today article gives us a peak at things to come if we cannot adequately pay for the health care restructuring contemplated by existing proposals. The new extension of health benefits and new subsidies, as the House bill, the bill reported from the Senate Health, Education, Labor and Pension Committee, and the President's outline would attempt to pay for them, will leave a funding gap that would force government-imposed rationing of life-saving medical treatment. The article, available at, describes a commentary published in the Journal of the American Society of Nephrology by Felix Knauf and Peter Aronson.

In their commentary in the prestigious journal, the pair openly notes that dialysis rationing would curb Medicare spending on chronic kidney failure in a big way. They regretfully acknowledge that to ration in this way "would almost certainly be politically unacceptable." ...But only 'politically' unacceptable....

The Yale doctors go on to write that "physicians are often willing to provide dialysis care to patients with greatly diminished quality of life.” They note disapprovingly that a survey of kidney doctors found that nearly half would be willing to continue dialysis in a patient who develops permanent severe dementia.

Here, note that they use the phrase "diminished quality of life." Under House and Senate HELP Committee proposals, if inadequate funding is combined with the emphasis on “controlling costs”, people with disabilities, those with poor “qualities of life”(whatever that will be interpreted to mean), the elderly and the terminally could be the first in line to have their treatment labeled 'ineffective' and denied. And, of course, it will not stop with dialysis.

The emphasis on reducing cost present in White House and Congress, coupled with an increasing openness in advocating rationing present in the Knauf/Aronson piece - makes for a real threat of rationing if the gap in available funding for healthcare becomes too wide.

See older posts and for positive solutions.

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