Before Rationing Healthcare, Let's Ration Waste

Waste, Fraud, Abuse, Death and Dying. Let’s Ration Healthcare Waste.

Contributing New York Times opinion writer Steven Rattnerbegan a recent column titled Beyond Obamacare with a rather provocative statement.

“We NEED death panels,” he said.

In the same year that the New England Journal of Medicine cautioned against using the word “reform” because it is still inflammatory, Rattner was using the “D” word.

 

Then, walking backward a few steps, he said “Well, maybe not death panels, exactly, but unless we start allocating health care resources more prudently — rationing, by its proper name — the exploding cost of Medicare will swamp the federal budget.”

Rattner, a veteran Wall Street financier and counselor to the Treasury secretary in the Obama administration, is best known as President Obama’s Car Czar because of his role leading the restructuring of the auto industry in 2009.

Now chairman of NYC Mayor Michael Bloomberg’s personal and philanthropic investment firm, he is taking head-on the ethical argument of just when a dying person’s last year of life actually begins. He argues that “the big money in Medicare (savings)” can be found “in reducing the cost of treating people in the last year of life, which consumes more than a quarter of the program’s budget.”

But isn’t that the primary reason the money was there in the first place? Wasn’t the very idea of Medicare to provide for the elderly and infirmed when they no longer can?

Mr. Rattner dismisses any meaningful savings from “unidentified efficiencies (the ever-popular ‘waste, fraud and abuse’).” But those villains are now being clearly identified. The Institute of Medicine recently released a comprehensive report detailing the amounts of each that could be saved if action were taken against them.

Would it not be better to ration healthcare dollars away from “waste, fraud and abuse,” than trying to determine a person’s final year of life and rationing care away from that person?

TeleTracking estimates that about $300 billion of the $765 billion the IOM says is wasted EACH YEAR by the U.S. Healthcare System could be saved by adapting industrial-style logistics efficiencies, including capacity management automation.

The argument of when it becomes fruitless to the patient and to society to sustain otherwise non-viable life will undoubtedly go on and on, as it should. However, there should be no argument regarding “waste, fraud and abuse.”

Let’s get rid of those culprits before we start wrangling with the issue of how valuable to society is the life of a dying person. Let’s redirect the money currently going down the drain to the uninsured and impoverished who deserve the same benefits that Medicare gives to the elderly.

What do you think?